Rival Systems Realize They Gain From Collaboration
Diabetes is an especially important area for new ideas, Potter notes, because 30-40% of the patients admitted to the health systems' hospitals present with diabetes, or diabetes is a complication of their admitting illness. "We're looking at attacking the places where we have the greatest chance of improving the outcome of the patient," she notes.
Another area that begs for improvement is the problem of diabetic patients who are non-compliant with their medications or other aspects of recommended care. An estimated 50% of patients with diabetes fall into this category, she says.
The ACO may decide to contact employers with suggestions that they work with their health insurers to restructure their benefit plans in such a way that those employees with diabetes who can show routine compliance with medication management may be allowed to forego paying a co-pay when visiting the doctor.
"We have to remember that we don't have enough money in our healthcare system to continue practicing the way we have been," Potter says.
Adds Klaasmeyer: "If we don't have some impact on reducing readmission rates, then the government and payers are going to do it for us."
Will all the friendly rivalry be put away? Probably not, but Potter and Klaasmeyer hope to make it work to their advantage. The new accountable care organizations culled by Methodist Health Partners and Nebraska Medical Center intends to use friendly competition to see which system's readmission prevention strategies work best.
"At some point, we'll sit back and look at our (readmission) rates and theirs and see who's the best. And then one or the other will ask, 'What are you guys doing to get those kind of numbers?'" Klaasmeyer says.
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Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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