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Many providers hesitate to embark on the transformation into accountable care organizations (ACOs) for two major reasons: anxiety about downside risk-based payments models and the challenge of balancing fiscal performance with the mission of delivering high-quality care.
To successfully transition into an ACO, providers must constantly refine workflows, processes, and performance indicators. To this end, analytics are the ticket to remaining on the cutting edge without teetering too far into the unknown.
When Success Depends on Data
The first step in ensuring ACO success is identifying ways to improve performance and push insights into clinical workflows. Then, once an initiative is in progress, ACOs need to monitor performance to ensure they are achieving the desired return on investment. With that information to guide strategy and negotiations, ACOs will be able to handle more risk-based contracts and greater contract complexity.
After they have plucked the low-hanging fruit in value-based care (VBC)—like reducing skilled nursing facility (SNF) length of stay and improving post discharge follow up— analytics can help ACOs prosper in increasingly complex risk-based payment models.
Success depends on access to the right data and making that data work. At a minimum, ACOs need claims data combined with clinical information from electronic health records (EHRs), then supplemented by other sources.