By Robert Capobianco

The last week in February, we joined the 30,000 healthcare professionals that descended on Orlando, Fla., for HIMSS 2011. HIMSS is a massive event with a plethora of content that can make any healthcare professional’s head spin. I’m looking forward to the various distillations from other market sectors as to what they found the main focus of the event was and the value they derived. The traditional healthcare alphabet soup was evident; however, one of the hottest topics was the enablement of accountable care organizations (ACOs) from the provider perspective.

From the various ACO conversations, I took away a few themes:

1. A need for more information around the granular issues of establishing and scaling an ACO initiative. The clarity being sought pertains to: How providers should be organized; what contractual changes are needed, if any; what aspects of collaboration are required; what the monitoring mechanisms will be for performance and quality; and how reimbursement will be executed for services. This type of start to ACO initiatives is reminiscent of the RHIO movement of 10+ years ago. The positive difference between the past and present is that we now know to start seeking out this information early in order to form better plans for implementation.
2. The provider community feels they need to be first to enter the ACO market. As we traveled throughout the event floor, there appeared to be a general buzz that the enablement of ACOs is somehow a race between provider and payer organizations. It is unclear if this is the best approach. It is reasonable to believe at this point that both parties have assets that would be better off together rather than apart (e.g., infrastructure, shared experience, etc.). A likely scenario that could materialize is a hybrid approach and not one dominate model. As in many environments, the synergy of a partnership with the shared knowledge, skills and attributes tends to produce a greater outcome than what an individual contributor can produce.
3. The enablement of ACOs is not just a technology or process change, it’s both. It has been widely publicized that the general market feels that the technology exists on the market today to enable ACOs and, furthermore, solve many of the initiatives coming from various reform mandates. However, in the words of one of our customers, if all you do is use new technology to implement the same old processes, you’ll likely end up with the same old results. In short, you will have made a change, but the outcome remains the same. By no means is it my intention to say the technology changes are in some way less complicated than process changes, but it did appear from the event floor that there is much more conversation around the technology aspect and less on the need to also change our processes.

We have entered another time of great change in the healthcare marketplace. Some of the changes are a blast from the past, while others are truly new. The opportunity for both payers and providers to make a positive impact on the quality and cost of care is within our reach. I came away from HIMSS with a strong conviction that the change we seek is not just a technology issue. The issues are coming to terms with how we think about our healthcare system and how we change our processes and technology in tandem in order to be in alignment with our objectives in terms of cost and quality. Technology is an enabler and readily available – we have to change our perspective in order for our actions to enable the technology to help us get there.

About the author
Robert Capobianco is director of marketing for Portico Systems, a leader in integrated provider management (IPM) solutions for payers. For more information on Portico Systems: www.porticosys.com.