Achieve Better Population Health and Accountable Care (ACO) Success
Healthcare is changing. Payers insist on getting more value for their money. In return, they offer financial rewards to forward-thinking provider groups who work cooperatively, strive for cost-efficiency and better health for their covered patient populations.
Lowering costs involves reducing variations in patterns of care, as well as avoiding unnecessary duplication and expense associated with pharmacy and imaging, length of stay, readmissions, emergency department (ED) and other cost-intensive services.
Through an integrated, proactive approach to population health management, medical costs can decrease and your organization can maximize its reimbursement for a job well done.
Providers and care delivery networks that embrace accountable care and population intelligence can help secure a better future for themselves, their patients, and society.
ACOs collaborate across disciplines for better population health
In the Accountable Care Organization (ACO) model, care providers in various settings work together to:
- Share information seamlessly
- Work to deliver the right care in the right setting
- Reduce duplication of laboratory and radiology tests
- Minimize the unnecessary use of expensive resources, such as hospital admissions and readmissions
- Manage patients with chronic conditions to focus on keeping these patients healthy and out of the hospital
- Help ensure patients get recommended screenings, so diseases can be prevented or identified earlier
- Understand and manage population risk
What an ACO needs to know to be successful
Care delivery networks that become ACOs will need to:
- Clinically integrate, per FTC requirements
- Understand the amount of risk inherent in a patient population
- Determine the level of risk they are comfortable taking on
- Negotiate bundled payments and risk-based contracts
- Proactively manage patient populations to help ensure the benchmarks are met and rewards earned
Success as an ACO depends upon mastery of two related but different fields:
- Population health management
- Financial and quality risk management
At McKesson, we’ve learned from experience that you can only manage what you can measure. Investing in a population health management platform helps turn your disparate electronic data into information that providers can use at the point of care. The same platform can also help your business side manage financial risk.
Timely data informs physicians at the point of care
Does your care delivery network have a lot of disparate electronic data? Do you make full use of it? Do you combine data from different systems? If your integrated information isn’t current, don’t worry – it can be.
McKesson’s population health management solution can help integrate data from disparate sources – EHRs, claims, labs, and pharmacy benefits (PBMs) – as well as clinical data entered by care providers in near real time.
At the point of care, our population health management solutions can help:
- Consolidate and display all past services and future events — such as scheduled tests and screenings — to eliminate duplication and aid in guideline compliance
- Support tracking of patients who refuse care or aren’t eligible for a specific guideline
- Identify patients who would benefit from intensive care management
- Let physicians track their own PQRS performance and earned incentives, and identify opportunities for improvement throughout the performance period
Better disease registries can change healthcare
Disease registries are at the core of population health management, but traditional registries offer little help. Historically, they’ve been a simple listing of patients with a common disease, such as diabetes. Our disease registries:
- Assigns patients to appropriate registries and care guidelines
- Allow multi-provider attribution – primary care (PCP) and specialists
- Support multi-prescriber pharmacy registries
- Let physicians exclude ineligible patients
- Identify patients in need of care, or more intensive care management
- Automate outreach with personalized workflows
- Coordinate patient services across the continuum of care
- Enable drill down to specific events, labs, provider reports and more
Measuring and managing the financial risk of a patient population
To manage financial risk, ACOs need a technical infrastructure to help manage the cost and quality of care being provided. All the data that is collected across the continuum of care can and should be put to work to inform the business side of your ACO.
Predictive modeling has emerged as an important tool for at-risk providers who need to manage population and patient health. ACOs use predictive modeling to:
- Understand population risk to inform contract negotiations
- Perform patient risk and likelihood of hospitalization stratification
- Identify high-risk patients for disease and intervention management programs
- Analyze populations served by commercial payers, Medicare and Medicaid
McKesson’s population health management solutions
Our population health management suite empowers ACOs with the insight to optimize care quality and outcomes at the individual patient and population levels, while helping to reduce medical and pharmacy costs.
- McKesson Population Manager™
Become clinically integrated and achieve better preventive care and disease management for patient populations with actionable details, compliance reporting, and streamlined workflows.
- McKesson Risk Manager™
Choose the right level of contract risk, engage your provider network in breakthrough performance, influence patient behavior, and achieve quality-of-care and financial targets.
Want more information?
Let McKesson be the cornerstone of your Population Health Management program. We'll help you find the right tools. Call 781.290.2511 to request more information.