Solutions for the Health Industry

John Wallace, vice president and general manager at Studiomaca Business Performance Services, answers questions about how health systems can successfully transition to becoming accountable care organizations (ACOs). Part 1 of a two-part Q&A.

What are possible consequences for health systems that try to take on the process of moving to ACOs internally?

Wallace: When health systems begin the transition to an ACO, they typically utilize resources inside that health system—so they ask these resources to oversee accountable care organization management in addition to their 40-hour-a-week jobs. The problem is, the resources have only a health system perspective, so they lack the alignment from a physician perspective.

When you read about ACOs not being successful, it’s usually due to an underestimation of the dollars it takes and not understanding the nuances of the relationship between the health system and the providers within the market.

Outsourcing is about experience, having a balanced approach for physician alignment, taking out cost where appropriate and capturing all of the volume to net out reduction of admissions and create a bridge from volume-based to value-based reimbursement.

At what point in the process of implementing an accountable care organization do health systems struggle the most? What kind of help do they need?

Wallace: Health care organizations particularly need help in the area of communicating clearly for physician alignment. They need to help physicians understand why the health system is going that way, what the related goals and metrics are, and what success look like.

Physicians will want to know how an accountable care organization will change what they do on a daily basis. Health systems need to communicate why they should change behavior and what they need to do to be successful.

What advice would you give to health care organizations in order to get buy-in from physicians on the shift to an accountable care organization? 

Wallace: Health care organizations should hire resources to make sure they have feet on the street and engagement within the environment. They should hold meetings with physicians at least monthly , showing and sharing information—it’s all about the information flow.

Stack rankings will be key, showing how other physicians in the community perform and analyzing metrics about quality. Physicians tend to be competitive, so they’ll want to be at the top of the charts.

Receive expert advice on how to implement an accountable care organization step by step by downloading the ACO Playbook.


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