ADVANCE for Executive Insight 1 ADVANCE for Executive Insight

CEO perspective
While many provider groups have decided to
wait until the “right time” to move away from
fee-for-service and into the world of value-based
care, other entities are moving swiftly into this
unchartered territory.
board and excited about this process.
On the Web
Visit our comprehensive
ACO resource center,
including news, articles
and multimedia. Go to
www.advanceweb.com/
executiveinsight and
click on ACOs under
“Resource Centers.”
Moving Quickly into Action
While BPN had some experience in quality
improvement and cost containment through
shared savings models and a Medicaid HMO,
the transformation to an early adopter ACO was
a significant step. No amount of strategic planning
could completely prepare us for the changes
ahead. Fortunately, our board believed that this
transition was inevitable and was very supportive
of our efforts to take a leap of faith into this
unchartered territory.
As your organization considers its approach,
there will likely be a great deal of planning, financial
modeling and analysis. While this is a crucial
step, many organizations may become stuck in
this phase and unwilling to proceed into an uncertain
environment. That’s why it is essential to
quickly move from the phase of contemplating
change to actually being willing to take action,
whether it is through a small pilot program or a
full ACO model.
Building a Technology
Infrastructure
To get to a true jumping-off point, organizations
should transition to a shared technology platform
that supports a team-based approach to
care as well as improved clinical decision-making.
At BPN and MPAC, we chose a global
solution that could support all of our needs for
clinical analytics, financial analytics, referrals,
authorizations, customized reporting and patient/provider
portals.
Without this flexible and robust system, we
could not have successfully transformed our
business processes to achieve the triple aim of
health reform — better care, reduced costs and
an enhanced patient experience. By connecting
physicians with meaningful insight at the point
of care, including targeted patient data and evidence-based
clinical practices, we empowered
providers to improve outcomes. At the population
level, this system also offered real-time data
that allowed us to develop targeted care management
and patient engagement strategies.
Offsetting Investments
Through Strategic Partnerships
Many organizations may struggle with the resources
and financial investments necessary
to make accountable care a reality. Fortunately,
strategies can help offset these investments.
Many payers are motivated to partner with providers
to build the infrastructure needed to support
quality-based improvements. For example,
BPN initially explored a shared savings model
through a payer partnership before moving into
a full ACO model. This allowed us to begin exploring
the realm of value-based care while benefiting
from financial incentives and support.
My career has included leadership roles in
both the payer and provider sides of the industry.
I strongly believe that the success of these new
models will depend heavily on whether these
parties can come to the table to develop strategies
that improve patient care and better manage
costs while maintaining mutual profitability.
The Time for Change is Now
Based on my experience, there is no perfect time
to pursue accountable care. If leaders and clinicians
are willing to make the transition, there is
no reason to delay the process. In fact, organizations
that take bold steps toward value-based
care today will be rewarded with growth opportunities
and the ability to have a seat at the table
with other innovative market leaders that are
crafting the future of healthcare delivery.
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