Information Interoperability: Successful Positioning For ACOs
 Pressing issues, among them the ever-shrinking Medicare Physician Fee Schedule and the threat of further imaging cuts wrought by the debt-ceiling agreement signed on August 2, might be looming larger than accountable-care organizations (ACOs) on radiology providers’ radar screens.
It is incumbent upon savvy players within the radiology sector, however, at least to consider how the advent of such organizations will affect them and what building blocks will be required in order to make the transition to an ACO model. ACOs are essentially networks of health-care providers (including various combinations of hospitals, physicians, and ancillary-service providers) contracted by Medicare and other payors to care for members of a defined patient population.
The ACO concept itself is not new; a failed initiative undertaken by the Clinton administration called for the establishment of similar networks of providers, called accountable health partnerships. “This time, things are a bit different,” according to Michael J. Mytych, a principal of Health Information Consulting in Hartland, Wisconsin. He notes that Medicare, in light of its financial woes, will continue to push the ACO concept. Other payors will follow suit, which will create the need for members of the radiology community to position themselves for alignment with some type of ACO.
In addition, Mytych points out, there remains the public perception that the US health care system is flawed and cannot continue down its current path. Even if the Patient Protection and Affordable Care Act undergoes modification or is somehow repealed, this perception will not go away, and legislators will push for some sort of change.
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Physicians Must Take Control of ACO ‘Construct’: A Conversation With Douglas G. Smith
 Recent media coverage of accountable-care organizations (ACOs) has included considerable speculation, both about how ACOs will evolve and about the manner in which health-care providers should proceed, in light of such evolution. Douglas G. Smith, FRMBA, is senior vice president of strategic initiatives at Integrated Medical Partners (IMP), a Milwaukee, Wisconsin-based provider of profit-improvement solutions for imaging practices. He says that the Medicare model for ACOs, created as a product of federal health-care reform, will not stick. “There are too many criteria, among other complications,” he notes.
Smith, who also serves as managing partner of Barrington Lakes Group (Barrington, Illinois), with which IMP merged in May 2011, shared his thoughts on the future of ACOs and the role of actionable information in planning for a move in that direction. RadAnalytics: How do you think that ACOs will evolve? What shape will they take? Smith:
There will almost certainly be several different models, including physician-driven ACOs and hospital-driven ACOs. There may be highly integrated models composed of group practices, and there may be ACO–look-alike models with limited integration—such as joint ventures and independent practice associations (IPAs).
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Analytics Open Doors to Strategic ACO Partnerships
 Accountable-care organizations (ACOs) are likely to assume multiple forms, but no matter which model they opt to follow, radiology practices and imaging centers must adopt a strategic, business-oriented approach to selecting the organization or organizations with which they wish to ally themselves, as well as to securing their positions as ACOs’ imaging providers of choice.
Involvement on the ACO front is a process that begins with clear and vigorous articulation of the near- and long-term value propositions for patients, the ACOs in question, and the ACOs’ other participants. Along with exercising persistence in pursuing ACO relationships, being able to articulate those propositions is the key to “getting a seat at the table,” according to W. Kenneth Davis Jr, JD, a partner in the Chicago, Illinois, office of law firm Katten Muchin Rosenman LLP.
During “Setting Up an ACO: The Good, the Bad, and the Ugly,” a panel discussion held on July 22, 2011, at the RBMA Executive Education Program in Scottsdale, Arizona, Davis advised imaging providers that they cannot go wrong in selling high-quality services and patient care as a component of the value proposition. Promoting such high caliber, he says, entails setting patient-care and practice-management benchmarks and ensuring—through careful tracking and monitoring—that they are consistently being met. It is even more significant that it means harnessing IT solutions and analytics to keep a tight rein on utilization management, so that efficiencies can easily be demonstrated to prospective ACO partners.
Moreover, such an effort involves the implementation of an order-entry solution with a decision-support component as an overlay on the utilization-management piece, as well as the integration of the PACS/RIS and electronic health records systems to provide a detailed picture of patient-care outcomes. Coordinating the use and flow of images and information within the care environment is essential.
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Satisfying Turnaround Times
The ability to meet or exceed turnaround times not only has become an increasingly critical competitive differentiator for radiology practices, but now serves as strong ammunition for use in proving their value to accountable-care organizations in a bid to become these entities' imaging providers of choice.
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Physicians Are Eager to Try ACOs, Executive Says
Many physicians recognize that the US health-care system is inefficient and must change. Therefore, they are eager to give accountable-care organizations (ACOs) a try. So says Jonathan Blum, deputy administrator and director for the Center of Medicare at CMS. Blum offered these comments during a briefing held to discuss with various health-care stakeholders the proposed ACO regulation issued by CMS in March. The briefing was hosted by the Indiana Health Information Exchange and the Employers' Forum of Indiana.
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ACOs Are Adopting Varied Payment Models
Accountable-care organizations (ACOs) are adopting one of four different approaches to creating new payment models, according to a new report sponsored by the Commonwealth Fund, a private foundation established to promote improvements in the US health-care system.
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