Reflections on ACOs and Unicorns

With March Madness in full swing and my Cougars of BYU out of the tournament, I can finally get back to work.

I’m sure you’ve now heard the line about how Accountable Care Organizations are like unicorns, “amazing creatures that have never actually been seen.” I enjoyed the difference pointed out by CMS Administrator Don Berwick, “at least we know what a unicorn looks like.” I’ve been wondering what impact this mythical ACO talk will have on healthcare providers. There doesn’t seem to be the same type of the paralysis that accompanied Meaningful Use. Ironically it could be the lack of clarity which allows many organizations to believe they can get there. Sure, there are many questions being asked:

• Can my patient accounting system and practice management system work together to handle bundled payments?
• How do I get my inpatient and ambulatory EMRs to talk together rather than stare at each other?
• How in the world will we communicate with homecare and long-term care organizations to share relevant clinical data?

However, I think the biggest changes will be on the backs of two key tools: HIE and Business Intelligence.

Look for these tools to go from the bench to the primetime. After spending years getting data into the system, we’ll now spend equal energy getting data out of the system and moving it into a new game plan. Twenty-year-old “decision support” tools will not be enough on the intelligence front, and two-year-old HIE solutions will take time to mature into what the next generation of health reform will need.

Like the classic banter between Miracle Max and his wife in “The Princess Bride” after Wesley takes the miracle pill — Think it’ll work? It would take a miracle — healthcare sometimes seems to enlist its own miracles and takes amazing 3-point shots at the buzzer to improve patient care. I look forward to watching ACOs take shape in the coming months.