Successful Systems of Care

Senior healthcare leaders have loudly complained that the government’s effort last spring at creating constructs to achieve accountable care are too restrictive and promise less reward than is necessary to compel their participation. Many still feel that way even after CMS relented somewhat by relaxing some of the standards by proposing multiple tracks for healthcare entities to achieve designation as a Medicare Accountable Care Organization.

If you don’t buy what CMS is selling regarding ACOs, it’s relatively easy to decide that coordinating care is not only a money loser, but that it could also be career-limiting for you as a leader. After all, it requires sacrifice for many in the short term, including powerful people who have control over your future, meaning your board (directly) and your physicians (indirectly). But jumping to such a conclusion would likely be a big mistake.

At least that’s the view of speakers at HealthLeaders Media’s recent Rounds event, held in June at Gundersen Lutheran Health System in La Crosse, WI. These leaders have already made big investments in driving the changes in care coordination that improve the lot of their patients—and the quality of their care. They do so because they try to ignore the cookbook recipes to deliver patient-centered, high-quality care, and instead forge their own way to focus care away from reimbursement realities and onto the best interests of the patient, trusting that the math will work out in the end.

It’s tough to muster the kind of political capital and courage to make significant changes in the way your health system manages patients when it seems things are going pretty well already. That was just the conundrum that Minneapolis–based Fairview Health found itself in when it developed a program to bring a more accountable system of care to its patients as well as prepare for the transition away from a fee-for-service reimbursement system.