Analytics Magazine Analytics Magazine, November/December 2014 - Page 26

healt h care a na ly t i c s I expect that by 2017, analytics will drive success for ACOs across the board. That’s good news for analytics professionals and product companies. The needle has started to move at last. Cost and return on investment of data analytics solutions pose significant barriers to adoption within many organizations. Pioneer ACO Data Shows Challenges Ahead CMS designed the ACO model to improve care by sharing data among multiple stakeholders. ACOs are a cornerstone of the Affordable Care Act (ACA). The idea is that by focusing on the holistic picture of a patient as they move through the healthcare system, providers can not only prevent wasteful duplication of diagnostic tests and procedures, but can also deliver the right care at the right time to the right patient. Such targeted intervention in turn will help in the prevention of unnecessary emergency room visits and costly hospital readmissions. Patients do not want to spend time in the hospital, so reduced hospitalizations and better health for individuals will drive up patient satisfaction. This is the “triple aim” that ACA wants the healthcare industry to move toward. The majority of ACOs, however, are far from achieving that goal. They have not found much success in improving key performance indicators such as patient safety, cost containment, efficiency and patient satisfaction [2]. Geisinger Health System, one of the leading physician-led healthcare systems in the country, mined its huge data sets, and it has found that an inverse After a long wait, the Center for Medicare and Medicaid (CMS) recently published quality and financial data reported from the Pioneer Accountable Care Organization (ACO) program. CMS started the program in 2012 to improve quality and health outcomes of patients by aligning payment incentives for providers. Of the 32 original Pioneer ACOs who participated in the program, 60 percent posted savings in the first year (2012) while 40 percent posted losses. The worrisome thing is by the second year about 50 percent of the initial participants dropped off the list. The cost incurred in the program by those who dropped off was much higher than their savings. However, CMS reported that in general the program saved Medicare $96 million in a two-year span. That is a good start, but clearly ACOs have mountains to climb in terms of data interoperability and data analytics. A recent survey of 62 ACOs by Premiere and eHealth Initiative found that 83 percent of ACOs are facing challenges in integrating analytics into their workflow. 26 | a n a ly t i c s - m a g a z i n e . o r g What is Holding Back Transformation? w w w. i n f o r m s . o r g