Aledade Puts Tools for Success in the Hands of Physician-Led ACOs

When Aledade launched in 2014, founder Farzad Mostashari, MD, former national coordinator for health information technology (IT), was spending about half the time talking to doctors not about his new company, but about value-based payments and what accountable care organizations (ACOs) were.

Aledade’s goal is to help independent, small primary care practices stay independent through ACOs so they can thrive and survive in the new value-based world, according to Dr Mostashari. Recently, Kelly Conroy joined as executive director of the Florida division and a senior advisor from the Palm Beach ACO, also known as A1001, the first Medicare ACO in the United States.

Ms Conroy has been participating in ACOs since the very beginning in 2012 and she has extensive experience with physician-led ACOs.

“[Physicians] were feeling very downtrodden and feeling like they had to move into bigger groups or be bought be a hospital,” she said. “I felt like [ACOs were] … the first thing that would allow the independent physicians to come together and actually be a part of the solution for healthcare.”

Physicians were particularly valuable because they already know what to do and they already have the relationships in place with their patients. ACOs simply gave them the tools they needed.

In June 2014, the same month Dr Mostashari launched Aledade, Ms Conroy wrote in The American Journal of Accountable Care about the cultural shift needed to make the ACO model a success. She wrote that the physicians at the Palm Beach ACO began to believe ni the ACO model because they were in the driver’s seat.

“It’s a population health lesson for physicians,” she said. “[ACO success] is really getting the right patients in front of the doctors at the right time in a systematic and standardized way.”

Dr Mostashari is prepared to push population health to the next level. He considers the traditional population health pyramid, with the 1%-5% of patients at the top who are really sick and require better care coordination in order to lower costs. While there are a lot of people dedicated to focusing on that aspect of healthcare, which is necessary, he wants to see the current view of population health go deeper.

“We also need to start going down that pyramid,” he said. “We need to start prevention for this whole population because 2 and 3 and 4 years from now you want to prevent those people from going up into the sicker part of the pyramid.”

Instead of 5 months from now, the healthcare industry should be looking at 5 years from now, he added, by implementing better chronic disease management so people don’t end up in the “trainwreck” stage.

ACOs can play a large role in improving population health, but one of the biggest challenges is the health IT. As the former national coordinator for health IT, Dr Mostashari is excited about the opportunities available now that were not possible 5 years ago. However, in the real world, many practices face interoperability challenges that are so much more disheartening than not being able to share information with other providers: they actually cannot properly access their own patient data.

“There is a tax on population health,” he stated.

So even though the practices working with Aledade are forward-thinking, early meaningful users, they’re still not being served well by their electronic health records because the systems require that the doctors pay for each interface, according to Dr Mostashari.

With the cost of interface fees, it can be too much of a burden for many small practices or new ACOs to access the clinical information that is available, but Ms Conroy explained that she has been so impressed with Aledade’s health IT capabilities and the tools it has available to assist doctors.

“[Aledade is] able to move so quickly in terms of getting data and analytics,” she said. “What I’ve been able to witness just exponentially increases the chances for success for physician-led ACOs because [Aledade] is able to give them what they need to make decisions.”