2015 ACO Survey Results Webinar

September 8, 2015

12:30 – 2:00 pm ET

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About eHealth Initiative

Since 2001, eHealth Initiative is the only national, non-partisan group that represents all the stakeholders in healthcare.

Mission to promote use of information and technology in healthcare to improve quality, safety and efficiency.

eHealth Initiative focuses its research, education and advocacy efforts in three areas:

– Business and clinical motivators

– Interoperability

– Data access and use

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This webinar was made possible through the

generosity and support of Phytel & Explorys!

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Agenda

12:30 – 12:35 PM Welcome and Introductions

12:35 – 12:55 PM Overview of Key Findings

12:55 – 2:00 PM Panel Discussion on Results

• Kevin Attride, Director, Clinical Health Outcomes, AMITA Health

• Bryan Bowles, Vice President, Solutions Marketing for Population

Health, Premier, Inc.

• Karen Handmaker, Vice President, Population Health Strategies,

Phytel, an IBM Company

• Craig Richardville, Senior Vice President & Chief Information Officer,

Carolinas HealthCare System

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ACO Survey Background

Third annual survey in conjunction w/eHI member

Premier, Inc.

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About the Survey

Conducted August 2015

Areas of focus include:

ACO coverage

Health IT infrastructure and interoperability

challenges

Data use and analytics

69 ACOs submitted a response to the

survey

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ACO Composition

80%

45%

36% 35%

25%

Medicare Commercial MedicareAdvantage

Employer-based Medicaid

Top contracting models:

• Shared savings (80% of ACOs)

• Fee for service + bonus (35% of ACOs)

ACO Coverage

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3%

14%

29%

13%

10%

3%

25%

Up to 5,000

5,001 to 10,000

10,001 to 25,000

25,001 to 50,000

50,001 to 75,000

75,001 to 100,000

More than 100,000

Number of Patients

10%

9%

16%

30%

16%

17%

1 to 50

51 to 100

101 to 250

251 to 500

501 to 1,000

More than 1,000

Number of Providers

Health IT Infrastructure

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Analytics software

– 82%

Electronic health

record

– 75%

Care management

software

– 62%

Computerized order

entry/e-prescribing

– 57%

Data warehouse

– 56%

Consumer Services

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48%

54%

57%

62%

66%

Notifications/reminders forgaps in care

Notifications/reminders forpreventive services

Patient navigators

Patient portal

Post-discharge/carecoaching

Health IT not supporting

patient engagement?

• 49% have difficulty

engaging patients

• 30% have electronic

forms to capture

patient data

• Only 20% offer

telemedicine for

patients

Interoperability

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39%

44%

7%3%

Number of Integrated

Health Information Systems

1-10 11-50 51-100 More than 100 3%

11%

28%

13%

25%

Nothing

$100,000 or less

$100,001 -$500,000

$500,001 to$1million

More than$1million

Cost of Developing ACO Interoperability

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Integrating Data Easier HarderNot

Integrated

Primary care 62% 30% 8%

Laboratories/Diagnostics 62% 18% 20%

Specialty care 18% 67% 15%

Public payers 47% 37% 15%

Private payers 30% 44% 26%

Long-term/post-acute/skilled

nursing13% 38% 48%

Behavioral health 10% 36% 53%

Palliative/hospice 24% 31% 46%

Home Health 22% 39% 39%

Pharmacy 42% 28% 30%

Data Use & Analytics

ACOs most often analyze:

In order to:

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• Claims data (96%)

• Clinical data (79%)

• Administrative data

(52%)

• Disease registry data

(39%)

• Patient-reported data

(38%)

• Identify gaps in care

(84%)

• Identify outliers in

cost/utilization (80%)

• Compare clinician

performance (77%)

• Measure/report on

quality (77%)

• Proactively identify risk

(68%)

Data Use & Analytics

Results are used to support:

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• Programs to address

specific high-cost or high-

utilization patient

populations (84%)

• Care transitions

management/care

coordination programs

(82%)

• Disease-management

programs (73%)

• Post-discharge programs

(68%)

• Development of evidence-

based clinical/care

guidelines (55%)

• Medication management

programs (38%)

How are they doing?

Cost savings – 68%

Improving quality measures – 54%

Reducing readmissions – 52%

Delivering preventive healthcare – 52%

Improving healthcare utilization – 50%

Reducing ED visits – 48%

Managing chronic disease – 45%

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Top Challenges

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Access to data outside my organization/network (78%)

Data integration (62%)

Change management (55%)

Cost of new health information technology (38%)

Obtaining provider commitment to participate (33%)

Key Takeaways

Data integration and care coordination

are large hurdles

Consumer facing tools are prevalent

FFS and upside-only share savings still

dominant

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Panel Discussion

Craig Richardville

Senior Vice

President & CIO

Carolinas

HealthCare System

Bryan Bowles

Vice President,

Solutions Marketing

for Population Health

Premier, Inc.

Kevin Attride

Director, Clinical

Health Outcomes

AMITA Health

Karen Handmaker

Vice President,

Population Health

Strategies

Phytel

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AMITA Health ACO & CIN

100,000+ Attributed Lives

• Value-Based Care Partnerships with

CMS, Blue Cross Blue Shield of IL, Cigna, Humana, AMITA Health

Employees

1,500+ Participating Providers

• 400+ Primary Care Physicians

Integrated Delivery Network

• 9 Hospitals

• 9 Urgent Care Locations

• 50+ PCMH Locations

• 10+ Post-Acute Care Partners

Located in Chicago’s Western and Northwestern Suburbs

AMITA Health is a faith based health system created by

Adventist Midwest Health & Alexian Brothers Health System

IBM Watson Health // ©2015 International Business Machines Corporation

Helping ACOs leverage HIT for population health

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Data and knowledge driven Every person

has a plan

Team basedAutomation to manage

a population down to

the individual

Phytel Observations

• ACOs are conquering first things first:

– Easy to access/easy to integrate data sources

– “Above the waterline” high cost/high risk patients for short term savings

• Going “below the waterline” will depend on new/easier HIT

capabilities

– Interoperability with services outside ACO core, such as behavioral

health, post-acute care and home health

– Analytics for more precise risk identification, including patient-reported

data and patient-centric registries

• “Smarter” care teams will leverage technology for more

personalized and timely intervention

– Referral management and care coordination

– Tailored messaging and education, telehealth, remote monitoring

– Care plans for every attributed individual

This webinar was made possible through the

generosity and support of Phytel & Explorys!

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