Population Health and Job Security

Twitter icon
Facebook icon
LinkedIn icon
e-mail icon
Google icon

A new report from Premier, Inc, indicates that hospital leadership is moving more slowly than previously signaled when it comes to active ACO participation. The report is based on a small sample, just 115 C-suite executives from 35 states, but it follows a similar survey conducted 18 months ago. Back then, more than half of the executives interviewed said they’d create or join an ACO by the end of 2013. The current survey indicates participation is closer to 1 in 4.

If hospital leaders want to keep their jobs, this is not necessarily a bad—or surprising—development.

The ACO model is so dramatically different than the current fix-the-sick approach to health care that major, systemic change—not to mention significant investments in infrastructure and reallocation of capital—will be required. Leaders on the provider side seek to improve patient care. The ACO aims to improve population health.

What is hospital leadership doing?

Quite a bit, it seems. More than 70% of respondents said they are making investments in lifestyle and wellness coaching, and 62.4% are investing in medical homes. Other key infrastructure investments being made to support transitional or end-of-life care (61.5%), home health (54.9%), patient risk stratification (45.9%), virtual care/telemedicine (41.3%), partnerships with payors (41.3%), integrating clinical, supply chain, and financial data (37.8%), and patient registries (30.3%).

About 18% of respondents reported having an active ACO, with large, urban, and IDN sites best represented. That compares with 4% in the spring of 2012. Another 26.1% percent expect to become active this year.
What about the 23.5% who say they will sit on the sidelines for the foreseeable future?

Providers that do not prepare to demonstrate accountability for their patient base are essentially planning for obsolescence. Slowly but surely payment models will change, and the traditional plain-wrap sick business will not be as profitable as the focused factory that turns out knee replacements, heart surgeries, and transplants. Hospitals maintaining the status quo will forfeit profitability to those organizations that morph into centers of health that reach into every corner of the community to engage patients in the pursuit of health. You may not own the gym but you sure better be in business with someone who does.

As the calendar opens on 2014, the message is this: Walk, don’t run, toward devising an ACO strategy for your organization. Most importantly, don’t do nothing at all.

Cheryl Proval

ACO Survey Executive Summary