Accountable Care: IT Gets Us Only Halfway There

Paul Cerrato | InformationWeek | September 24, 2012

It's hard to imagine a successful accountable care organization (ACO) that doesn't rely heavily on IT. ACOs require that clinicians meet a long list of quality measures to prove that they're acting in an accountable way to reduce costs without reducing the quality of medical services. And most of those metrics are best tracked with software.

But the very foundation upon which ACOs are built could be shaky, making software tools only so effective. Let me explain.

Consider the Medicare-based Shared Savings Program ACO. It's a group of doctors, hospitals, and other healthcare providers that has agreed to work together to deliver high-quality care to at least 5,000 Medicare beneficiaries for at least three years. To obtain government financial rewards, the ACO has to report on 33 quality standards and show improvement in 32 of them within those three years. In a nutshell, if the ACO can prove that the cost of caring for these ACO patients is less than what the Centers for Medicare & Medicaid Services (CMS) would anticipate under the standard fee-for-services model, the ACO providers get to share in some of the savings.