5 Takeaways From the ACO Coalition Spring Live Meeting

At the spring live meeting of the ACO & Emerging Healthcare Delivery Coalition in Scottsdale, Arizona, attendees heard presentations and participated in workshops that discussed better integration of care, improved use of technology, and the future of healthcare and the Affordable Care Act (ACA).

To learn more about the Coalition and the fall live meeting, which will be held October 20-21, 2016, in Philadelphia, Pennsylvania, visit the conference page.

Here are 5 takeaways from the 2-day meeting that was held April 28-29.

1. Providing better behavioral health is key

Currently, the healthcare industry is trying to care for people with behavioral health issues in the medical sector, which is leading to their care being delivered in a piecemeal way, explained Roger Kathol, MD, CPE, president of Cartsian Solutions, Inc, and a professor psychiatry at the University of Minnesota.

“If you have separate behavioral and medical, you are at a disadvantage already,” he said.

Now with accountable care organizations (ACOs) are accountable for both the health and cost of the population it services, addressing both medical and behavioral issues will lead to improved outcomes, he added.

And John Santopietro, MD, chief clinical officer of behavioral health at Carolinas Healthcare, spent his own presentation outlining the telemedicine solution Carolinas has implemented in order to better serve patients with behavioral health issues.

Carolinas has created a virtual behavioral health provider team that can be deployed to care for patients in multiple practices and can provide telepsychiatry visits.

“If you do it that way, you can deploy [the team] much more effectively,” Dr Santopietro said.

2. ACO accreditation is voluntary … for now

Michael Massey, MD, from Baylor Scott & White Quality Alliance, outlined the voluntary ACO accreditation that his organization went through with the National Committee for Quality Assurance.

As of now, only a small handle of ACOs have gone through this accreditation process, which is meant to identify which ACOs could be good partners. Seeking accreditation allowed the Quality Alliance to see where it had gaps and more work to do to provide quality care, Dr Massey said.

As of now, this voluntary ACO accreditation is just in the beginning stages and most valuable for the ACOs to look internally and see how they can improve, Dennis Scanlon, PhD, professor of health policy and administration and director of the Center for Health Care and Policy at the Pennsylvania State University, explained during the panel discussion following Dr Massey’s presentation.

Lysette Cournoyer, a consultant, added that the voluntary accreditation for ACOs is similar to how accreditation started for patient-centered medical homes (PCMHs), and similar to PCMHs, accreditation for ACOs is likely to expand in the coming years.

3. Technology is connecting providers to patients and to other providers

Carolinas’ virtual behavioral health provider team was just one example of how technology is allowing providers to have a wider reach. The health system has used its virtual team to look at patients coming into the emergency department in order to get access to patients who need help early on.

In Oregon, technology is being used to connect primary care providers with specialists who can help with difficult cases. Mark Lovgren, director of telehealth services at Oregon Health and Science University, explained that Project ECHO demonopolizes a specialist’s knowledge. The program runs for 40 weeks with presentations from specialists and actual cases from the participating primary care providers.

“The idea is that with repeated exposure to these difficult cases, everyone participating will feel more comfortable with them,” he said.

4. Precision medicine is the future of medicine

During the keynote presentation, Len Fromer, MD, FAAFP, executive medical director of Group Practice Forum, delved into precision medicine and how it can be incorporated into accountable care and the structure of ACOs.

The 2 may seem look opposing concepts, but precision medicine promotes the idea targeting treatment to reduce overall costs.

“You do the right thing, at the right time, at the right dose with the right patient … and the total cost of care goes down not up—even if the cost of the treatment might be a lot of money,” he explained.

He also explained that he expects to start seeing quality measures tied to moving precision medicine forward in the United States.

5. Based on the possible outcome of the election, the ACA will not be repealed

During a panel discussion on the future of healthcare, panelists Michael Chernew, PhD, of Harvard Medical School, Patricia Salber, MD, MBA, of The Doctor Weighs In, and Bruce Sherman, MD, of Buck Consultants, A Xerox Company, spent a lot of time focused on what the ACA has done so far and the future sustainability of it.

One thing the panelists agreed on was that more and more states will continue to expand Medicaid, especially if it looks like the ACA won’t be repealed at the federal level.

“If it looks like [the ACA] is really here to stay, you’ll see more states expanding,” said Dr Chernew.

However, the presidential election is not the only important one—local elections could have a big impact. The Democratic frontrunner, Hillary Clinton, will continue forward with the ACA and a Republican Congress will remain unlikely to pass a repeal bill. However, if Donald Trump wins as the Republican candidate and the Congress is not controlled by the Republican Party, Trump is unlikely to push for a repeal of the ACA.

“There’s what Trump says, and what he will do,” explained Dr Salber.

Dr Chernew added that Trump doesn’t seem fully committed to repealing the ACA, although he suspects that if a Republican-controlled Congress sent a bill to repeal the ACA to Trump, he would sign it.