The first set of statistics on the efficacy of Accountable Care Organizations (healthcare ACO’s) has been published. There were really no surprising stats. The simple fact that was proven by the study was that when you take a vested interest in patients well-being and interact with them between appointments; DUH. They become more compliant and contribute to their own well-being and that makes the stats look good and patients feel better. Blood pressure is more controlled when you ask a patient to record it every day then check to make sure they are so doing. Blood sugar levels come down when patients follow the protocols and you know they follow them because you check them either through home devices or mobile apps.
But the real question is “can healthcare ACO and large multi-specialty practices accomplish this AND keep costs down at the same time?” Now the theory is (and it does make some long-term sense) when patients begin to experience the value of healthcare being their own health and not just their access to healthcare, they will use less costly healthcare services i.e. hospitalization and the costs will go down. But until that happens, the government is willing to pay practices and ACO’s and even bonus them for accomplishing how they define “value”. Right now they are getting paid for recording results. No small feat.
Getting the relationships right between all the participating entities is the challenge currently. Hospitals are taking the lead in ensuring re-admissions don’t occur, but working with the primary physicians and facilitating the communication that is necessary to accomplish that takes time and effort. Payers are conducting patient seminars, opening store-fronts for engagement of patients, and exchanging good information with practices and patients to promote wellness. The maturing of these relationships while data is shared and analyzed will help the ACO effort.
Technology and ‘one-on-one’ patient communication seems to be the right combination to accomplish wellness. Both are expensive. Technology can capture and store huge amounts of data. Technology can utilize mobile devices to communicate daily measurements back to a central data bank. Trained medical personnel, usually nurses, trend the data and communicate back to patients and primary physicians. Effective? Yes. Expensive? Yes. The real statistics will not only show positive value in the wellness of patients, but also what it really costs to deliver that kind of value.