Across the country, hospitals and health systems are transitioning to accountable care organizations (ACOs). What does it take to do that?
"With ACOs, it's not just about being a hospital – it's about being an integrated care delivery system and bringing together primary care doctors and specialty care doctors," said Catherine Leape, assistant director of recognition programs at the National Committee for Quality Assurance (NCQA), which offers an ACO accreditation. "It's all about flexibility and the ability for organizations to really create that network of accountable care. In our program, the primary care offices are the central base of an ACO."
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Many years ago the Children's Hospital of Philadelphia (CHOP) began to see a need to develop care processes and systems, said Michael Apkon, MD, senior vice president and chief medical officer at CHOP, and began transitioning their health system into an ACO-type infrastructure with better coordination of care and cost-effective care across the continuum.
In February, CHOP's work was acknowledged by the NCQA when the organization announced that CHOP had earned its ACO accreditation, making CHOP among the first five organizations in the country (and the only children's hospital) to earn this accreditation.
According to Leape, and Kiran Johal, assistant director of product development at NCQA, to receive the accreditation, CHOP underwent a rigorous assessment that focused on the evaluation of 14 standards and 65 elements that included: ACO structure and operations, access to needed providers, patient-centered primary care, care management, care coordination and transitions, patient rights and responsibilities and performance reporting and quality improvement.
"We've been building towards this for a while," said Apkon. "[The accreditation] helps us better tell the story of how we can deliver value in the community, so as we are working with payer organizations or other potential healthcare partners, it gives us a way to clearly and credibly describe the value of the systems we built."
[See also: ACOs don't have to be daunting, according to experts]
University Hospitals of Cleveland (UH), an integrated system of hospital, clinics and physician offices, became a Medicare ACO last summer. Medicare ACOs are groups of doctors and hospitals that share responsibility for providing high-quality, low-cost care to Medicare patients and share in any cost savings they achieve for the Medicare program.
At the heart of UH's ACO transition, said Eric J. Bieber, UH's chief medical officer, is communication – better communication across the care continuum to improve health through prevention and utilizing technology for more communication, which cuts down on duplicative care, among other things.
"How can we tie the different pieces of care together with the fewest medications, fewest visits, but with everyone understanding what is going on?" he said.
"At the crux," Bieber said, "it's about the patient being at the center, and it's more about wellness and prevention than ever before."
[See also: ACOs key to healthcare overhaul, Berwick says]