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ACO End-to-End Solutions Go Beyond EHR, Pop Health Technology

EHR technology is one of many health IT systems necessary for success in adopting ACO models, a realization that has led to a new market for developers of end-to-end ACO solutions.

ACO Adoption

Source: Thinkstock

By Kate Monica

- The lack of standardization in implementing accountable care organizations (ACOs) has created a demand for solution vendors capable of assisting healthcare organizations in seamlessly adopting these value-based care models.

A recent report from Chilmark Research evaluates the 10 leading ACO solution vendors for their capabilities and core competencies in providing a range of services for successful ACO adoption in an effort to help healthcare organizations make informed decisions about which vendor best suits their needs.

Vendors covered in the report include only those fulfilling the definition of enabling vendors — that is, those offering end-to-end solutions for payer-agnostic value-based administration. The report hammers home the traditional EHR and population health management vendors supply but a portion of the systems and services necessary for supporting provider ACO needs.

End-to-end solutions extend beyond simply offering ACO HIT to aspects of ACO adoption such as project management, readiness assessments, program infrastructure services, consulting, and technology support.  

In adopting a new business model focused on quality of care over services delivered, the authors recommended healthcare organizations focus on reimbursement for quality and value and management of both population and individual health.

“To succeed in the quality and value-focused population health market, [healthcare organizations] require guidance, skills, and business processes not inherently found in-house,” wrote Chilmark authors in their report, “Vendors (ACO Enablers) have responded to market need and ACO growth with a combination of services, business processes, and technologies to enable more rapid execution.”

The authors outlined assessment criteria and information on ACO technology requirements and challenges before naming the vendors selling full ACO HIT solutions.

These vendors provide the benefits of several other health information technology vendors combined with the necessary IT offerings of EHR vendors, technology range of PHM vendors, and specific, personalized services of consulting firms.

Because of the complexity of ACO adoption, possessing the EHR technology necessary to accommodate the value-based care model is not enough to ensure success. 

With over 1,300 ACO contracts issued nationwide, the value-based care model has become increasingly popular among healthcare organizations since 2012 but still covers only 10 percent of the population. ACO Enabling Vendors aim to facilitate increased ACO adoption through consolidating the myriad services healthcare organizations need for success with the model.*

Editor's note: A previous version incorrectly stated the number of ACO contracts.

"Approximately half of these vendors have established a value proposition to support a unique market sub-segment of ACOs, while the other half offer generalized solutions to the ACO and VBC market at large," said Jennifer Rogers, Chilmark Research analyst and author of this report. "We anticipate the ACO market will coalesce around the more differentiated ACO Enablers, with the non-differentiated focusing instead on other VBC services as revenue opportunities."

The authors investigated the market and technology obstacles of enabling an ACO through briefings with participating vendors and secondary research to answer questions about the technology gaps ACOs must fill to be successful, the present challenges to filling those gaps, the observed effectiveness of technology and legacy vendors in filling those gaps, and areas ACOs can simplify their technology infrastructure to streamline solutions, among other questions regarding ACO adoption.

In closing, the report addresses the future of ACOs in the current value-based care system. As ACO HIT Enabling Vendors also lobby with CMS and commercial payers to set the stage for the future of value-based care models, these vendors have unique insight into where ACOs are headed.

“The public and private markets will continue to experiment and identify model designs that solve for the cost burden of healthcare to employers, consumers, and the nation, all while improving value delivered for cost paid,” authors predict, “New rules for provider reimbursement codified in MACRA rules will drive the market forward through bonuses to Medicare providers for participating in alternative payment models (APMs) such as ACOs.”



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