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    COPD one of ‘most important’ diagnoses to manage in ACOs

     

    MHE: How will these proactive steps benefit your involvement in the NGACO Model?  

    Bernhardt: We hope to leverage our Indiana University Health Plan and our ACO claims data to pinpoint some of the key drivers of whether COPD care is going well or not, and then track those drivers by physician. Also, we will marry those drivers to patient outcomes by physician.

    As a result, we will receive feedback on whether what we are recommending is actually paying off in good, efficient care. This information can then be shared with individual physicians to see how they are doing and how their treatment strategies may vary or match up with what we consider the standard of care. 

    MHE: Are there any liabilities to the NGACO Model?

    Bernhardt: When you engage in a NGACO Model, you as a healthcare system are taking upside and downside risk. Therefore, the model all of a sudden becomes a great motivator for the system to look at care and to start filtering that risk down to your physician groups or smaller physician practices.

    The model is also a potent motivator to start using the data.

    In addition, when you engage in the NGACO Model, you know upfront, at the beginning of the year, [which patients are included in the model], which is different than the traditional ACO Model, where you find out your cohort after the fact.

    The next generation model also allows you to track your outcomes. You have more insight into utilization data. This provides you a lot of power to collect performance data. It has been a big boon to us.

    For example, being able to go to a primary physician and say that your patients with COPD are utilizing the emergency department too much becomes much more real to that physician when you have data on 200 or 500 patients.

    As we compile results from our NGACO Model, I anticipate it will bring a sharper focus to our physicians on how well they are managing specific disease processes like COPD.

     

     

     

     

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