The Naked Hospital seminar I attended recently in Nashville was neither about nudity nor hospitals. In reality, it was about accountable care organizations. The seminar hosts got us in the door with a provocative title, then treated us to a rousing discussion, and more than a little grumbling, about ACOs. After the clichés were out of the way (ACOs are like unicorns!), we got an unexpected treat: an incredibly insightful presentation by Harry Reynolds, the director of Health Industry Transformation for IBM. Reynolds spoke forcefully of the role of patients and providers in healthcare reform. Some questions posed by Reynolds concerning ACOs included:
How do you engage patients with a $2,500 deductible who see their doctor once a year?
Is it any wonder some physicians are ready to get out of healthcare, considering the time, money and technology investments necessary to keep a stand-alone practice viable.
Can the clunky apparatus we call Medicaid deliver innovative, flexible benefit design.
How ready are providers for the transition from ICD version 9 to ICD version 10.
On the latter, a brief primer. ICD is the International Statistical Classification of Diseases and Related Health Problems. In a nutshell, ICD is a coding system that is the foundation of provider reimbursement. Anything that a provider does to you or gives you has a code attached. You can see the footprints of ICD on any EOB statement from your health plan or any itemized bill from your doctor. Under ICD-10, tens of thousands of new codes will be added and each code represents the start of a plan of care one that physicians will be measured by and reimbursed by. The federal government is requiring all providers to make the transition to ICD-10 at the same time that they are tackling meaningful use, ACOs, reducing hospital readmissions, the list goes on.
So what's the bottom line? Healthcare reform is rolling out intricate models of care that have more moving parts than a Swiss watch. Bottom line number two. I'll give the honors back to Harry Reynolds: ACOs are happening, so get on board or you're going to be in serious trouble.
The Naked Hospital seminar reinforced that ACOs have become everyone's favorite three-letter four-letter word. But the seminar also reinforced the importance of integration, health information exchange and care coordination to improve healthcare quality in the 21st-century.
Isn't that what it's all about?
For more about ICD-10, visit the HealthLeaders-InterStudy healthcare reform blog. Can you DRG it, posted in May.