WIHI - A Podcast from the Institute for Healthcare Improvement
Health & Fitness:Medicine
Date: September 27, 2012
Featuring:
One of the best-kept secrets about US health care this election season is the degree to which change and transformation are coming, no matter what happens in November. You won’t hear “global payment” or Medicare Shared Savings Program mentioned as often as “individual mandate” in the current political debate, but ask anyone leading a health care organization today which issue keeps them up at night, and it’s definitely payment reform. In general terms, the entire system is shifting from paying for volume – lots of procedures – to paying for value, or how well patients are cared for over time and across the continuum.
Accountable care organizations (ACOs) are one critical new reflection of this migration, and they’re being encouraged by public and private payers alike. What do we know about the more than 200 ACOs that have formed in the US thus far? It’s still early in the process, but some smart people are keeping a close eye on ACOs, and we’re going to be talking with a few of them on WIHI.
As Director of Population Health and Policy at the Dartmouth Institute for Health Policy and Clinical Practice, Dr. Elliott Fisher is leading a major study of the factors enabling ACOs to get up and running and to successfully implement new forms of care delivery. WIHI host Madge Kaplan welcomes Dr. Fisher to the show to share what he and his team of evaluators have learned thus far. He’ll be joined by leaders from Tucson Medical Center, one of the nation’s earliest adopters of the ACO concept. Dr. Palmer “Pal” Evans and John Friend from Arizona Connected Care both say that one of the biggest hurdles for newly forming ACOs is to let go of the notion that hospitals can and should run the show. That’s not where the future is headed, both say, and they’re learning this in spades in Arizona. They’re also learning how to build will and buy-in from mostly independent physicians, a situation that’s typical of most US hospitals.
There are plenty of uncertainties ahead, but Elliott Fisher, Pal Evans, and John Friend agree that ACOs or something similar are likely to be a feature of reform for the forseeable future. They share their perspectives and answer questions on WIHI.
For some background on Tucson Medical Center’s entrance into the ACO experiment, please take a look at these Commonwealth Fund case studies published earlier this year.
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WIHI: Health Care’s Newest Improvers: Patient and Family Advisors
WIHI: The Newest Innovator on the Block: Center for Medicare and Medicaid Innovation
WIHI: A Legible Prescription for Health Care
WIHI: Alert to Change: New Models for Residency Work Hours
WIHI: The Power of Specialty Care – and the Necessity to Use It Wisely
WIHI: The Patient Activist
WIHI: Finding the Will to Bend the Cost Curve
WIHI: Nursing’s New Roadmap: Education, the Workforce, and Health Care Quality
WIHI: The Leaders Needed for the Changes Health Care Needs
WIHI: The Power to Detect and Reduce Harm: IHI’s Global Trigger Tool and Adverse Events in the US
WIHI: Reducing Readmissions, Restoring Revenues: Making Good Care Count
WIHI: The Buzz about Medical Training: It’s (Slowly) Changing
WIHI: Leaders Never Stop Learning
WIHI: Against All Odds: Maternal Survival in Ghana and the US
WIHI: Unprofessional Behavior Not Permitted Here
WIHI: The Image of Better (Radiation) Imaging Practices
WIHI: Learning by Data and by Doing: Low-Cost, High-Quality Health Care in America
WIHI: Coaching’s the Thing for Primary Care Practice
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