Accountable Care

Payers need information for risk adjustment and providers need data to close gaps in care, says Piyush Khanna of CareFirst BCBS.

Not only are the HHS information blocking disincentives too steep, but they could also interrupt accountable care organizations' shift to value-based care, the organizations argue. Meanwhile, the EHR Association says the regs are "too narrowly focused."

Despite challenges such as data privacy concerns and the need for seamless integration into existing systems, the trajectory of AI development in healthcare is promising as tools continue to improve, says Alex Mason of FTV Capital.

David Morris, EVP at Cedar Gate Technologies, explains that the model allows for a gradual approach to risk for more conservative and less experienced ACOs, in comparison to ACO REACH, which requires a greater tolerance for risk.  

With telemedicine, the time for patients coming out of the ER or a convenience clinic to see a primary care provider has gone from weeks to 24-72 hours. And virtual care has helped the health system achieve a 72% completion rate of Medicare annual wellness visits.

Moving into 2024, there will be a greater commitment to accountable care models – and the technologies that support nontraditional care scenarios – as healthcare organizations aim to improve patient outcomes, reduce health inequities and control costs.

The CMS-based disincentives outlined in the proposed rule from ONC published Monday would penalize hospitals under the Promoting Interoperability Program, eligible clinicians under MIPS and ACO participants under the Medicare Shared Savings Program.

Clinical decision support improves outcomes, ROI and the move to value-based care, says Yaw Fellin of Wolters Kluwer Health. 

"If we can manage patients on the front side of their diagnoses, and continue that management longitudinally, it's going to have a significant impact on the escalation of patients' chronic conditions," one expert says about the value of preventative care.

Pushing the needle on value-based care will require buy-in from employers, says Susan Dentzer, president and CEO of APG.