Accountable Care Success

Accountable care Success  Since enactment of the Affordable Care Act, what do you think has been our biggest area of success so far?  What factors have contributed to our ability to be successful? 

Argumentable, the biggest area of success is the mass adoption of electronic health records (EHR). With the adoption of EHR solutions, it is inevitable that EHR implementation has opened doorways to additional barriers that will need to be addressed. Nonetheless, the steady growth of EHR implementation which has shown to increase from 72% of all Hospitals with a certified EHR in 2011 to 96% in 2017, a growth of 28%. Supports a rapid path towards implementing a solution that will work to improve ACO efficiencies (ONC, 2017). Likewise, EHR’s aid in creation of meaningful data and is a critical solution towards value-based care.

Although technological advancement can be largely attributed to the Health Information Technology and Economic Clinical Health (HITECH) Act, through financial incentives funded by meeting Meaningful Use criteria. The Affordable Care Act (ACA) created an impetus for EHR adoption. Care models to improve patient care and transform a fee for service industry to value-based industry drove EHR implementation. The metrics and new solution requirements for Accountable Care Organizations (ACO) would be difficult without the use of advanced EHR solutions (Adler et al, 2014).

The data and metric measurements that can be accomplished by use of EHR data is hoped to improve patient care and reduce costs. According to Spooner, Reese, and Konschak (2012) EHR’s support bidirectional data transfers with other organization among many other benefits. These benefits alone enable care coordination and complex patient management internal and external to an organization. These systems also impact population health and can be leveraged to report disease. With reference to ACO’s Davis and colleagues identified multiple success factors of EHR implementation which include engaged physician planning, tracking of qualitative and quantitative benefits, and workflow standardization amongst other benefits (as cited by Spooner, Reese, & Konschak, 2012).

Moreover, outcomes to reduce admission rates by means of care coordination and payment incentives instilled by the ACA, are made possible by the availability of EHR’s. Community Based Care Transition Program (CCTP) mandated by the ACA is a 5 year 500-million-dollar program to focus on reduction of readmission rates. The key to success is a partnership between hospitals and community-based organizations (Kocher & Adashi, 2011). This process relies heavily on successful transmission of data and warehousing for shared patient data. This takes us back to our need to implement EHRs, and what I feel is a fundamental accomplishment of the ACA to encourage a rapid implementation of EHR technology.  

What the technology does is allows for organizations to bridge the communication barriers. These barriers prevent successful implementation of ACOs or other programs to reduce healthcare costs. Since we are now starting to see how EHR’s impact healthcare. As mentioned I feel that it’s important to point out the impact the ACA has had in encouraging EHR implementation. Moreover, the impact EHR implementation will have on improving the aforementioned areas where healthcare has failed which include communication barriers, patient care management, and costs.

References:

Adler-Milstein, J., DesRoches, C. M., Furukawa, M. F., Worzala, C., Charles, D., Kralovec, P., ... & Jha, A. K. (2014). More than half of US hospitals have at least a basic EHR, but stage 2 criteria remain challenging for most. Health Affairs, 33(9), 1664-1671.

Kocher, R. P., & Adashi, E. Y. (2011). Hospital readmissions and the Affordable Care Act: paying for coordinated quality care. Jama, 306(16), 1794-1795.

Office of the National Coordinator for Health Information Technology. (2017). 'Non-federal Acute Care Hospital Electronic Health Record Adoption,' Health IT Quick-Stat #47. Retrieved from: dashboard.healthit.gov/quickstats/pages/FIG-Hospital-EHR-Adoption.php.