2015 ACO Survey Results Webinar September 8, 2015 12:30 2:00 pm ET **Audio for this webinar streams through the web. Please make sure the sound on your computer is turned on and you have speakers. If you need technical assistance, please contact ReadyTalk Customer Care: 800.843.9166.
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About ehealth Initiative Since 2001, ehealth Initiative is the only national, non-partisan group that represents all the stakeholders in healthcare. Mission to promote use of information and technology in healthcare to improve quality, safety and efficiency. ehealth Initiative focuses its research, education and advocacy efforts in three areas: Business and clinical motivators Interoperability Data access and use 3
This webinar was made possible through the generosity and support of Phytel & Explorys! 4
Agenda 12:30 12:35 PM Welcome and Introductions 12:35 12:55 PM Overview of Key Findings 12:55 2:00 PM Panel Discussion on Results Kevin Attride, Director, Clinical Health Outcomes, AMITA Health Bryan Bowles, Vice President, Solutions Marketing for Population Health, Premier, Inc. Karen Handmaker, Vice President, Population Health Strategies, Phytel, an IBM Company Craig Richardville, Senior Vice President & Chief Information Officer, Carolinas HealthCare System 5
ACO Survey Background Third annual survey in conjunction w/ehi member Premier, Inc. 6
About the Survey Conducted August 2015 Areas of focus include: ACO coverage Health IT infrastructure and interoperability challenges Data use and analytics 69 ACOs submitted a response to the survey 7
ACO Composition 80% 45% 36% 35% 25% Medicare Commercial Medicare Advantage Employer-based Medicaid Top contracting models: Shared savings (80% of ACOs) Fee for service + bonus (35% of ACOs) 8
ACO Coverage Number of Providers Number of Patients 17% More than 1,000 More than 100,000 25% 16% 501 to 1,000 75,001 to 100,000 3% 50,001 to 75,000 10% 30% 251 to 500 25,001 to 50,000 13% 16% 101 to 250 10,001 to 25,000 29% 9% 51 to 100 5,001 to 10,000 14% 10% 1 to 50 Up to 5,000 3% 9
Health IT Infrastructure Analytics software 82% Electronic health record 75% Care management software 62% Computerized order entry/e-prescribing 57% Data warehouse 56% 10
Consumer Services Post-discharge/care coaching Patient portal Patient navigators Notifications/reminders for preventive services Notifications/reminders for gaps in care 66% 62% 57% 54% 48% Health IT not supporting patient engagement? 49% have difficulty engaging patients 30% have electronic forms to capture patient data Only 20% offer telemedicine for patients 11
Interoperability Number of Integrated Health Information Systems 3% 7% Cost of Developing ACO Interoperability More than $1million 25% $500,001 to $1million 13% 44% 39% $100,001 - $500,000 28% $100,000 or less 11% 1-10 11-50 51-100 More than 100 Nothing 3% 12
Integrating Data Easier Harder Not Integrated Primary care 62% 30% 8% Laboratories/Diagnostics 62% 18% 20% Specialty care 18% 67% 15% Public payers 47% 37% 15% Private payers 30% 44% 26% Long-term/post-acute/skilled nursing 13% 38% 48% Behavioral health 10% 36% 53% Palliative/hospice 24% 31% 46% Home Health 22% 39% 39% Pharmacy 42% 28% 30% 13
Data Use & Analytics ACOs most often analyze: Claims data (96%) Clinical data (79%) Administrative data (52%) In order to: Identify gaps in care (84%) Identify outliers in cost/utilization (80%) Compare clinician performance (77%) Disease registry data (39%) Patient-reported data (38%) Measure/report on quality (77%) Proactively identify risk (68%) 14
Data Use & Analytics Results are used to support: Programs to address specific high-cost or highutilization patient populations (84%) Care transitions management/care coordination programs (82%) Disease-management programs (73%) Post-discharge programs (68%) Development of evidencebased clinical/care guidelines (55%) Medication management programs (38%) 15
How are they doing? Cost savings 68% Improving quality measures 54% Reducing readmissions 52% Delivering preventive healthcare 52% Improving healthcare utilization 50% Reducing ED visits 48% Managing chronic disease 45% 16
Top Challenges Access to data outside my organization/network (78%) Data integration (62%) Change management (55%) Cost of new health information technology (38%) Obtaining provider commitment to participate (33%) 17
Key Takeaways Data integration and care coordination are large hurdles Consumer facing tools are prevalent FFS and upside-only share savings still dominant 18
Panel Discussion Kevin Attride Director, Clinical Health Outcomes AMITA Health Bryan Bowles Vice President, Solutions Marketing for Population Health Premier, Inc. Karen Handmaker Vice President, Population Health Strategies Phytel Craig Richardville Senior Vice President & CIO Carolinas HealthCare System 19
AMITA Health ACO & CIN 100,000+ Attributed Lives Value-Based Care Partnerships with CMS, Blue Cross Blue Shield of IL, Cigna, Humana, AMITA Health Employees 1,500+ Participating Providers 400+ Primary Care Physicians Integrated Delivery Network 9 Hospitals 9 Urgent Care Locations 50+ PCMH Locations 10+ Post-Acute Care Partners Located in Chicago s Western and Northwestern Suburbs AMITA Health is a faith based health system created by Adventist Midwest Health & Alexian Brothers Health System
Helping ACOs leverage HIT for population health Data and knowledge driven Every person has a plan Automation to manage a population down to the individual Team based IBM Watson Health // 2015 International Business Machines Corporation 21
Phytel Observations ACOs are conquering first things first: Easy to access/easy to integrate data sources Above the waterline high cost/high risk patients for short term savings Going below the waterline will depend on new/easier HIT capabilities Interoperability with services outside ACO core, such as behavioral health, post-acute care and home health Analytics for more precise risk identification, including patient-reported data and patient-centric registries Smarter care teams will leverage technology for more personalized and timely intervention Referral management and care coordination Tailored messaging and education, telehealth, remote monitoring Care plans for every attributed individual
This webinar was made possible through the generosity and support of Phytel & Explorys! 23