Collaboration Across Practices

ACOs are paving the way for an expected shift from a volume-based reimbursement model to one based on quality and efficiency. It is already clear the model will include some degree of financial responsibility—or accountability—for the practice.

An Effective ACO Model will Include:

• Patient-centered medical homes that deliver primary care and coordinate with other providers
• Aligned networks of specialists, ancillary providers and hospitals focused on outcomes
• Explicit care integration and coordination mechanisms
• Payor-provider partnership relationships and reimbursement models identified under healthcare reform that facilitate and reward high value, not high volume, healthcare
• Population health information infrastructure to enable community-wide care coordination

Unlike volume-based reimbursement, which encourages the provision of more care, prepayment forces providers to switch the emphasis of care from merely treating sickness to also maintaining or improving health to prevent avoidable illness and unnecessary care. Hence it is clear that, if physician groups aim to succeed as ACOs or ACO members, they will have to move to a population health management approach that is aligned with the new reimbursement model. 

Using Technology to Re-Engineer the Primary Care Practice

By applying technology to population health strategies that continually identify, assess, and stratify provider panels, physician groups can use automation to augment the role of care teams, manage the patient population more effectively and efficiently, drive better outcomes, and decrease overall cost, as demanded by ACO payment incentives.

Group practices must shift from an acute-visit-based perspective to a population-based approach, and they must use the latest information technology to automate the PBPH model as much as possible. When they have achieved those two goals, they will be a long way down the road to becoming successful ACOs.

How Phytel’s Solutions Support the ACO Model

Phytel’s solutions are designed to enable practices to effectively manage their entire population. Our health IT automation tools help physicians reach out to patients who need services, keep track of their population in the most efficient way, extend the capabilities of their EHRs and reduce the burden of routine care management work.