Accountable Care Organizations (ACOs) face significant challenges when transitioning from the fee-based healthcare models to value-based healthcare models while at the same time trying to attain significant financial performance improvements and quality care for patients. It is always difficult to balance all those aspects and have everything rolling in the desired direction.
For one, Accountable Care Organization Solutions success and sustainability strongly depend on factors such as;
- Effective data management,
- Precise documentation,
- Measure attainment,
- Quality performance,
- Risk score accuracy, and
- Submission capabilities.
It also depends on how good they are at proactive population management as well as the integration of unique strategies that help improve financial and clinical results in this fast-changing healthcare industry.
Accountable Care Organizations and Data Analytics
Data analytics offer a compact solution to most of the challenges faced by ACOs in the achievement of their goals. Advanced data analytics help ACOs achieve meaningful impact in clinical and quality outcomes by enabling them to assess and analyze care management as well as financial performance in healthcare organizations. This, in turn, enables them to conclusively deduce tactics that help in improving standards of care while simultaneously maintaining cost efficiencies.
Here are the key aspects of data analytics in ACOs that you should be keen to note about;
Data Analysis and Reporting
This is one of the key aspects to consider when looking at ACO solutions. An ACO’s ability to manage, integrate and analyze data from the various sources in a healthcare organization such as claims, benefits, lab results, patient reports, and hospital ADT data (Admit discharge and transfer data) among others, is essential to attaining significant progress in quality improvement, quality measurement, analysis and reporting, risk score accuracy and care harmonization.
When looking for a tech company to help you with data analytics, this is a crucial aspect to consider. Ensure that you understand in detail how their systems will help your organization in delivering and executing interventions that drive high impact and value.
Quality Analytics and Improvement
Quality management through strategic and improved analytics as well as targeted interventions help in delivering improved quality scores. With the right partner, ACOs can even be able to get patient and provider predictive analytics. Predictive modeling of provider, patient, and organization level data with other variables such as patient behavior, provider effectiveness, and region benchmark helps identify gaps in care delivery.
Plus, with continuous analysis which is data-driven, it is easy to carry out precise targeting and therefore rest assured that the right interventions will be made for the right patient, in the right place, and at the right time.
Shared Savings Accuracy
With the right partner providing you with data analytics services, you can be able to maximize the shared savings by just accurately assessing and recording the health status of your patient population. And by proactively assessing data-driven patient risk profiles, analytics help ensure there is accuracy in the capturing of patient risk scores within the adjusted calculations and therefore expand the pool of shared savings.
Quality reporting and submission
Quality reporting and submission of clinical outcomes to the Medicare Shared Savings program helps other ACOs participating in the program to access the information and use it in aiding their course. With a good data analytics company, your ACO will be linked up to plenty of electronic medical records as well as traditional paper-based records, all of which are reviewed and prepared to make the going easy for you.
These are just but a few of the many aspects of accountable care organization solutions. It is therefore apparent that for an ACO to achieve its goals while also observing all the state and federal requirements, data analytics are crucial.
Many of us have an expectation of instantaneous answers to our questions. This is also true when it comes to healthcare and accountable care organizations. When we are sitting down with our doctor at our yearly physical, we all understand that we are probably not their only patient, they probably don’t remember much of anything about us from a year ago, but expect that they will be able to renew a prescription, advise us on things that we should be doing better, and let us know anything new that we should be adding into our lives. For a yearly physical, this may not be as critical as it would be if you had been brought into an emergency room to a hospital that you may never have been to. When those medical professionals are able to bring up your information and know that you have an allergy to nuts or a kind of medication, they can more appropriately work to handle your situation with that sort of prompt response to directives. Thus, decreasing the probability of negative treatments or long-term health effects that could have been avoided. By having our information right there on the computer, the doctor is able to quickly assess what has happened, see if anything new has come up and provided the advice that we are seeking. This can all be done right there instead of having to return for repeated appointments, and if necessary, when information can’t be provided on the spot, it can be sent to us or accessed through the patient portal. This kind of accountability is one of these things that make giving and receiving care a lot easier.