Key drivers of shared savings and the role of health information technology.

1. Accountable Care Organizations:
Savings, Quality, & Health Information Technology
Robert Bond, MBA | robert@acoadvantage.com | 484.431.3015 (mobile)
ACOAdvantage (www.acoadvantage.com)
ACOAdvantage Breakthrough Performance in the Health Reform Era
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2. Framework to Guide ACO Shared Savings
Levers Influencing Cost & Quality of Care
Levers affecting DEMAND 1 Promote health and wellness amongst
individuals and populations
Actively manage demand
for health care products
and services Ensure value-conscious consumption
2
among providers and patients
What levers
must an ACO Levers affecting RISK
follow to
promote quality, Actively identify high-risk patients and
3
cost develop individualized care plans
effectiveness,
Levers affecting COST
and service Promote efficient creation of capacity for
4
sustainability Develop resources and labor, infrastructure, and innovation
infrastructure to foster
Design and develop new models for
cost reducing innovations
5 care delivery which promote
in care processes
efficiency and quality
Levers affecting QUALITY Promote improvements to care
6
coordination amongst providers
Promote and implement
activities focused on Promote evidence-based medicine &
improving care process 7
clinical knowledge
outcomes
ACOAdvantage© Collect, analyze, and disseminate
8
performance and outcome metrics

3. Accountable Care Organizations Model Principles
Key Principles for Formation of an ACO
Performance
Local Accountability Shared Savings
Measurement
ACOs will consist of locally based Reimbursement model for ACOs is “You can’t manage what you don’t
providers. Benchmarks for ACO termed “Shared Savings.” Shared measure. “ ACOs will provide metrics on
spending are based on historical savings combine fee-for–service with clinical process, outcome measures, and
spending patterns and risk-adjusted cost savings. the patient experience.
based on patient mix. The local ACO
is accountable for costs, quality, and
capacity.
ACOAdvantage©
Source: "The Promise ACOs." Accountable Care Organization Learning Network. The Engelberg Center for Health Care Reform at Brookings and the Dartmouth Institute for Health
Policy & Clinical Practice , n.d. Web. 18 Apr 2011. <http://www.acolearningnetwork.org/who-we-are/about-the-network>.
2

4. Accountable Care Organizations Model Principles
Key Principles for Formation of an ACO
1 Continuity of Care
Continutity of care provides for the end to end
care of patients. Information and instructions
are passed from provider to provider.
2
Alignment of Incentives
Shared savings create an
Key alignment of financial care and
Components outcomes. Traditional models of
of care (e.g., fee-for-service) can
Accountable result in a financial discentive for
Care care improvement
3 Infrastructure
Infrastructure
Information technology system through ACOAdvantage©
which data is gathered, organized, and
shared.

5. Formation Stages of an Accountable Care Organization
Evolution of Provider Focus on Health IT Infrastructure
Beginning Intermediate Advanced
Health of
Population Scope of Provider Focus
 Measures are
more fully
focused on
 Limited clinical and outcomes and
patient survey data patient
is available experience
 Providers focus Providers focus
increases towards on population
the full continuum health and share
 Providers use
of care accountability
process based
for care
Discrete measures
Patient  Focus is on discrete
patient encounters ACOAdvantage©
Encounters
Level of Health IT Infrastructure and Data Availability
Paper-Based Records / Sophisticated EHR / PHR &
Claims-Based (e.g., Medical, Laboratory, Pharmacy) Rich clinical and patient survey data

6. ACO Success Enabled by Health IT
Key Functions Supported by Information Technology
Manage Risk Performance Measurement
Providers will need to develop ACOs will need to master performance
capability in managing financial risk. measurement to manage risk and
Most providers will be able to handle Manage Measure achieve savings. Metrics include
performance risk; however, they Financials Performance population health, quality of care, and
lack capabilities to manage patient satisfaction.
insurance risk.
Coordinate Care
Coordinate Building the Train Providers & Staff
Coordination of care between Train
providers and settings will be Care Successful Both providers and staff will
essential. New or redesigned ACO Providers require training on new
& Staff workflows, processes, and team
workflow processes will reduce
work. Changing provider
duplicate efforts, pass information
behavior is a particular
seamlessly, and become patient
challenge.
centric.
Engage Provide
Engage Patients Patients Information
Engaging patients in caring for their Provide Information
health will require providers to develop Accurate, real-time information is
or acquire capabilities in disease essential to the success of the ACO.
management, personal health records, Especially vital is clinical decision
patient portal, and patient education. support at the point of care. Providers
Legend ACOAdvantage©
will need evidence-based clinical
guidelines, alerts, and reminders.
= Relies on Health IT

7. Accountable Care Organizations Nationwide
Examples of ACOs Formed or in Formation as of Q2 2011
Steward Healthcare Cape Code Healthcare
Boston, MA Hyannis, MA
Wyoming Med Center
Casper, WY Montifore Med Center
Catholic Healthcare West Advocate Healthcare New York, NY
Hill Physicians Louisville, KY
San Ramon, CA Atlantic Health
Morristown, NJ
Norton Healthcare Carilion Clinic
Healthcare Partner Louisville, KY Roanoke, VA
Torrance, CA
Banner Health
Arizona
Tucson Medical Center
Monarch Healthcare Tucson, AZ
Irvine, CA
ACOAdvantage©

8. Accountable Care Organizations
Robert Bond, MBA
Partner
ACOAdvantage (www.acoadvantage.com)
robert@acoadvantage.com | 484.431.3015