Patient Motivation a Must for Accountable Care

This article was originally published in the September issue of Managed Care Contracting & Reimbursement Advisor.

Accountable care is not a new concept to ­physicians, but the Patient Protection and Affordable Care Act of 2010 (PPACA) is creating new pressure to get ­patients more ­actively involved in their care, says Erica ­Drazen, managing partner for emerging practices with the healthcare consulting firm CSC in Waltham, MA. Not only will patients' health improve, but the practice's ­revenue also can benefit.

PPACA includes several provisions that will tie ­reimbursement to performance, including:

• Value-based purchasing program: Beginning in ­October 2012, CMS will provide hospitals that meet established performance or improvement standards with value-based incentive payments.
• Excessive hospital readmissions penalty: ­Also b­eginning in October 2012, CMS will reduce ­reimbursement to hospitals with excess readmissions for pneumonia, heart failure, and acute myocardial infarction.
• Shared savings program: Groups of providers will be able to establish accountable care organizations by January 2012 for the care of Medicare FFS beneficiaries.

"Clearly, change is afoot. As healthcare organizations become more accountable for the care they provide, engaging patients in their health, wellness, and ­medical decisions will be ­increasingly ­important," ­Drazen says. "However, the biggest challenge lies in how to successfully motivate patients to take an active role in their health and medical decisions."

Along with CSC research analyst Caitlin Lorincz, Drazen recently authored a report, Preparing for Accountable Care, which details the four dimensions of health IT tools needed to successfully engage patients and how healthcare organizations can move ahead in implementing these tools. (The full report can be found online.)

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