Transforming to Value-Based Care: Learning From NAACOS

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Abhinav Shashank
Fri 14 Oct 2016
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Leaders from more than 550 ACOs gathered in Washington, D.C. for NAACOS fall conference. These were esteemed healthcare professionals like ACO leaders, clinical leaders, administrators, executives, payers exhibitors, and CMS officials who shared invaluable insights on current healthcare standards and the scopes of improvement in them. We had the chance to interact with these renowned healthcare personalities and understand various matters of paramount importance. Speakers shared their opinions and ideas that would make healthcare equitable and affordable, here are our key takeaways from this NAACOS conference.

 

1.) Care coordination: The key to evolving health care

Improvement in quality of care is a primary focus, and advanced Care Coordination is one the best ways to achieve this goal. Care Coordination is now the ultimate goal of value focused healthcare organizations to provide efficient delivery of health care services within and across the system. It has its challenges and roadblocks, but people are optimistic to achieve it with advancing methodologies.

 

2.) Data Integration and information flow

The growing networks of healthcare organizations consistently demand easy access to data. Interoperability is still one of the most discussed topics, but there is more to it and organizations now focus on performing holistic population health management with data integration capabilities. The pace of integration is a matter of concern for most of the organizations as they look to capitalize on the data post its integration.

A common opinion was that EHRs must serve as platforms for the integration of care across multiple settings ensuring information sharing and access from patients and providers to researchers and policy makers and vice-versa, enabling a bidirectional flow of information. This would not only make sure that medical records are complete and up to date, but will also speed up informed care decisions with less miscommunication.

 

3.) Policy Changes

With CPC+ and MACRA around the corner, there are going to be multiple changes in various policies and incentivization. MIPS will include a CPIA category which will demand improvement activities from practices, the performance on these will decide the shares of organizations. All of this has created a complexity around the incentivization process. One way to take a shot at this would be healthcare organizations developing their strategical skills, providing training and support tools, and creating a better organization culture. The other way would be to improve those financial incentives and make them performance-based. Be it pay for performance or public reporting program, patient-centered care would be the core approach.

 

4.) The importance of post-acute care coordination

To be able to deliver the best care, practices have focused on post-acute care. These services can be as substantial as rehabilitation facilities and home health services or as slight as grocery, meals or cleaning services. Having skilled nursing facilities, discharge planners, and care managers is fundamental and essential, but when supported by automated procedures post-acute care can be coordinated properly. These procedures can assist in designing an apt care plan for high risk patients.

 

5.) MACRA

The truth is widely accepted: MACRA is an intricate and incredibly complex law and will take time to get used to. It would be implemented from 2017, but the first payment adjustments won’t take place before 2019; giving Eligible Clinicians enough time to be aware of their performance and what could be their possible savings. Since time is of the essence, it’s highly important that providers and payers incorporate this change and understand it.

There’s a lot of uncertainty as to how will MACRA affect a practice. Questions regarding the payment adjustments under the Quality Payment Program like how is it different from Sustainable Growth Rate (SGR) keep increasing. Thus, providers would need a MIPS calculator to calculate their savings before the payout year.

Practices are poised to move forward with a patient-centric approach to bring the necessary changes. Transformation in every process takes time, the reshaping rarely visible, but takes place nevertheless. And once it is solid enough, it manages to stay. There was a lot to learn, there will always a be a lot to learn, we just have to implement it in the best possible way.

 

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Tags: Accountable Care, Healthcare, Updates
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Abhinav Shashank
Transforming to Value-Based Care: Learning From NAACOS
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