Performance of Accountable Care Organizations: Health Information Technology and Quality–Efficiency Trade-Offs

2021 ◽  
Author(s):  
Chenzhang Bao ◽  
Indranil R. Bardhan
Keyword(s):  
Information Technology ◽  
Health Information Technology ◽  
Health Information ◽  
Financial Incentives ◽  
Care Delivery ◽  
Healthcare Providers ◽  
Cost Of Care ◽  
Accountable Care Organizations ◽  
Accountable Care ◽  
Trade Offs

Under a traditional fee-for-service payment model, healthcare providers typically compromise the quality of care in order to reduce costs. Drawing on data from a national sample of accountable care organizations (ACOs), we study whether financial incentives offered under the Affordable Care Act led to fundamental changes in care delivery. Our research suggests that effective use of health information technology (IT) by ACO providers is critical in balancing competing goals of quality and efficiency. Unlike hospitals that did not participate in value-based care initiatives, ACOs were able to generate better quality outcomes while also improving overall efficiency. Furthermore, ACO providers that used health IT effectively demonstrated better patient health outcomes due to greater information integration with other providers. In other words, ACOs created value by not only reducing the cost of care but also improving patient outcomes simultaneously. Our research provides a roadmap for practitioners to succeed in a value-based healthcare environment and for policy makers to design better incentives to promote interorganizational information sharing across providers. Our findings suggest that healthcare policy needs to incorporate appropriate incentives to foster effective IT use for care coordination between healthcare providers.

Using health information technology to manage a patient population in accountable care organizations

2016 ◽  
Vol 30 (4) ◽  
pp. 581-596 ◽  
Author(s):  
Frances M Wu ◽  
Thomas G. Rundall ◽  
Stephen M. Shortell ◽  
Joan R Bloom
Keyword(s):  
Information Technology ◽  
Data Integration ◽  
Health Information Technology ◽  
Health Information ◽  
Patient Population ◽  
Care Management ◽  
Accountable Care Organizations ◽  
Accountable Care ◽  
Electronic Health Record Data ◽  
Content Type

Purpose – The purpose of this paper is to describe the current landscape of health information technology (HIT) in early accountable care organizations (ACOs), the different strategies ACOs are using to develop HIT-based capabilities, and how ACOs are using these capabilities within their care management processes to advance health outcomes for their patient population. Design/methodology/approach – Mixed methods study pairing data from a cross-sectional National Survey of ACOs with in-depth, semi-structured interviews with leaders from 11 ACOs (both completed in 2013). Findings – Early ACOs vary widely in their electronic health record, data integration, and analytic capabilities. The most common HIT capability was drug-drug and drug-allergy interaction checks, with 53.2 percent of respondents reporting that the ACO possessed the capability to a high degree. Outpatient and inpatient data integration was the least common HIT capability (8.1 percent). In the interviews, ACO leaders commented on different HIT development strategies to gain a more comprehensive picture of patient needs and service utilization. ACOs realize the necessity for robust data analytics, and are exploring a variety of approaches to achieve it. Research limitations/implications – Data are self-reported. The qualitative portion was based on interviews with 11 ACOs, limiting generalizability to the universe of ACOs but allowing for a range of responses. Practical implications – ACOs are challenged with the development of sophisticated HIT infrastructure. They may benefit from targeted assistance and incentives to implement health information exchanges with other providers to promote more coordinated care management for their patient population. Originality/value – Using new empirical data, this study increases understanding of the extent of ACOs’ current and developing HIT capabilities to support ongoing care management.

Health Information Technology in the Era of Care Delivery Reform

JAMA ◽  
2012 ◽  
Vol 307 (24) ◽  
Author(s):  
Asaf Bitton ◽  
Lydia A. Flier ◽  
Ashish K. Jha
Keyword(s):  
Information Technology ◽  
Health Information Technology ◽  
Health Information ◽  
Care Delivery

scholarly journals Managing the patient safety risks of bottom-up health information technology innovations: Recommendations for healthcare providers

2018 ◽  
Vol 25 (1) ◽  
pp. 7-13 ◽  
Author(s):  
Mark A. Sujan
Keyword(s):  
Information Technology ◽  
Risk Management ◽  
Health Information Technology ◽  
Health Information ◽  
Management Strategies ◽  
Healthcare Providers ◽  
Local Health ◽  
Health It ◽  
Bottom Up ◽  
Patients At Risk

Health information technology (IT) offers exciting opportunities for providing novel services to patients, and for improving the quality and safety of care. Many healthcare professionals are already improving services through the development of numerous bottom-up local health IT innovations. Such innovations from the ground up are to be welcomed, but healthcare providers are struggling to develop processes for managing the risks that come with the introduction of health IT into clinical processes. I argue that too often the main strategy appears to be one of organisational ignorance. This puts patients at risk, and it threatens the successful adoption of health IT. I recommend that healthcare providers focus on strengthening their processes for organisational learning, promoting proactive risk management strategies, and making risk management decisions transparent and explicit.

scholarly journals Maximizing Performance in Medicare’s Merit Based Incentive Payment System: A Financial Model to Optimize Health Information Technology Resource Allocation

2020 ◽  
Vol 57 ◽  
pp. 004695802097123
Author(s):  
David M. Kauffman ◽  
William B. Borden ◽  
Brian G. Choi
Keyword(s):  
Information Technology ◽  
Health Information Technology ◽  
Health Information ◽  
Small Groups ◽  
Financial Incentives ◽  
The United States ◽  
Payment System ◽  
United States Department ◽  
Incentive Payment ◽  
Financial Model

Participation in the Medicare Quality Payment Program’s Merit Based Incentive Payment System (MIPS) has forced many healthcare administrators to strategize how to achieve success under value-based payment systems. A financial model was constructed to determine the marginal utility of compliance with various MIPS measures. Solo, small, medium, large, and very large practices were modeled using available data and final rules published by the United States Department of Health and Human Services (HHS). The model analysis found that small groups were generally incentivized not to comply with MIPS measures. Conversely, larger organizations were found to have strong financial incentives to maximize pursuit of MIPS measures. Incentives to pursue interoperability investments were projected to be generally under $10 200 for small organizations but approximately $690 000 for very large practices whereas the health information technology (IT) resources necessary to pursue these measures may not have nearly the same range of costs. In light of these findings, small groups may be driven to join larger groups as large groups continue to capitalize on their larger incentives to pursue MIPS measures. As financial success under MIPS is dependent on scale, healthcare systems that pursue consolidation may achieve greater success under quality payment programs similar to MIPS which include the newly proposed MIPS Value Pathways (MVPs).

A Bounded Health Information Technology System Design Approach to Support Community-Based Care Delivery

2015 ◽  
Vol 5 (1) ◽  
pp. 32-45 ◽  
Author(s):  
Liam Peyton ◽  
Jaspreet Bindra ◽  
Aladdin Baarah ◽  
Austin Chamney ◽  
Craig Kuziemsky
Keyword(s):  
Information Technology ◽  
Cloud Computing ◽  
System Design ◽  
Health Information Technology ◽  
Health Information ◽  
Care Delivery ◽  
Healthcare Delivery ◽  
Systems Design ◽  
Community Based ◽  
Mobile Form

Health information technology (HIT) offers great potential for supporting healthcare delivery, particularly collaborative care delivery that is provided across multiple settings and providers. To date much of HIT design has focused on digitizing data or processes on a departmental or healthcare provider basis. However, this bounded approach has not scaled well for supporting community based care across disparate providers or settings because of the lack of boundaries (e.g. disprate data and processes) that exist in community based care. Cloud computing approaches that leverage mobile form applications for developing integrated HIT solutions have the potential to support collaborative healthcare delivery in the community. However, to date there is a shortage of methods that describe how to develop integrated cloud computing solutions to support community based care delivery. In particular there is a need for methods that identify how to incorporate boundaries into cloud computing systems design. This paper uses a three year case study of the design of the Palliative Care Information System (PAL-IS) to provide system design insight on cloud computing approaches that leverage mobile forms applications to support community care management.

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