Commentaries on accountable care organizationsThe SSM Health Care Approach to Achieving “True North”: Improving Health Care Quality While Reducing Costs
Section snippets
Final Rule Assessment
SSM Health Care St Louis thoroughly investigated the opportunity to participate in the Medicare Shared Savings Program (MSSP) as an ACO and weighed components of the application to determine if this program was in the best interest of the organization and, ultimately, the people in the communities that we serve. The main components that warranted major considerations included the following.
Our Approach to Improving Quality and Reducing Cost: “True North”
SSM Health Care St Louis has determined that its path forward is to respond to the fundamental factors driving the health care industry in the context of the overall US economy, rather than conform to the requirements set forth by the MSSP. We have designed a deliberate path, True North, which synchronizes the economics of its transformation with the operational changes necessary to accomplish that transformation. SSM Health Care St Louis recognizes that transformation and change must occur,
Moving Forward With Value-Based Design
There are, of course, major hurdles and risks associated with moving from the current system toward True North. The most obvious, of course, is that the payment structure of Medicare and most major managed care organizations remains encounter based, which makes investment in efforts to optimize health and decrease encounters financially self-destructive. In addition, the process of assembling a like-minded team of physicians and other health care professionals involves moving from the old
Conclusion
In response to the challenge of reducing health care costs while improving quality, SSMSL has embarked on the transformation of its organization driven by trends that, unabated, threaten the future stability of its mission as well as the quality and strength of the US health care system. Rather than enrolling in the MSSP as an ACO, SSMSL has chosen instead to think in terms of a functional definition of accountable care: creating an organization capable of assuming and managing global clinical
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Accountable care organization pathways: Diverse but ultimately parallel
2012, Mayo Clinic ProceedingsCitation Excerpt :No author and organization whose views are reflected in the commentaries published in this issue of Mayo Clinic Proceedings thinks that the goals of the PPACA or the ACO experiments are misguided. Those that chose not to participate are proceeding to develop ACO-like capacities, Baylor Health Care System quite rapidly because of its more sophisticated information technology infrastructure and long-time quality improvement experience; SSM Health Care St Louis5 and Health Choice6 more slowly but about as fast as they think they can, which is faster than many organizations are moving today. The question for all will be, can they find payers willing to move toward value- and performance-based payment at their preferred pace, for without payment reform and aligned incentives among the full range of physicians and hospitals, real-care transformation cannot occur and the goals of more efficient high-quality care and better health will not be realized.