Accountable care organizations of any shape, size or form face similar, much-talked about challenges, such as trying to manage population health and improve patient outcomes to keeping cost-per-patient low.
Another, less-discussed challenge ACOs have to take on in order to be successful is reporting: Medicare Shared Savings Program and Pioneer ACO participants must report to CMS on patient health outcomes to track quality and outcome performance. "The reporting aspect is really vital, considering some of what we're being graded on is improvement in health," says Eric Bletzinger, chief executive officer of Cumberland Center for Healthcare Innovation, a physician-driven ACO based in Cookeville, Tenn.
This is easier for some ACOs than others. In CCHI's case, the ACO is made up of 29 independent physician practices spread through 14 counties in rural Tennessee. There are 12 different electronic medical record systems in the ACO, according to Mr. Bletzinger. "They're independent practices…each physician implemented EMR on their own timeframe and picked the one that worked best for them," he explains.
Even though some practices in CCHI are on the same EMR system, there is variance even between how physicians in each practice use the system. "Having one EMR system doesn't mean that a piece of data you're trying to get is in the same field every time," Mr. Bletzinger says.
For CCHI, the sheer number of EMR systems and the variance between systems made reporting to CMS a daunting task for the MSSP ACO, and other ACOs across the country can run into this exact problem. ACOs tend to tie together physicians from different practices and even multiple hospitals that all bring their own style of data entry and EMR use to the table.
To overcome the hurdle of disparate and varying EMR systems to successfully report necessary data to CMS, CCHI decided to use a reporting and analytics tools from Clinigence. Bringing in outside help ended up being critical to CCHI's reporting success, says Mr. Bletzinger.
"The biggest benefit from our perspective with them is the ability to take a number of EMRs and the same data from different fields and consolidate it," he explains, effectively fixing the ACO's two main reporting concerns in one fell swoop.
The fix was so effective, in fact, that in its first year reporting to CMS, CCHI was able to report on 100 percent of the patients CMS asks for. "We were very excited about it," Mr. Bletzinger says. "It was essential to our survival, because that's what CMS is looking for."
With the reporting challenge tackled, CCHI is ready to move on and possibly even grow. "We are looking to expand, carefully," Mr. Bletzinger says. "As much as we can, we'd like to be able to work alongside [big hospital organizations] and have independent physicians in our group." And even as CCHI grows, the analytics tool will be able to pull data and help the ACO maintain 100 percent reporting to CMS.