The ability to achieve significant change depends on the type of organization, Wunker says. For example, a health system in a small rural town has enough market power that it has to stay in business?it is, in effect, too small to fail.
"But when it comes to business strategy, for a lot of healthcare systems that's not going to cut it," he says.
Moving forward no matter what
Premier, the Charlotte, NC?based performance improvement alliance, has gathered together 40 organizations that are betting that collaborative care coordinated by a hospital or health system is the healthcare business model of the future.
The collaborative's aim is to help each member develop its own skills, team, and operational capabilities needed to become an effective ACO "capable of lowering costs by improving care coordination, efficiency, quality, and patient satisfaction," according to Premier.
The collaborative will build the knowledge and expertise needed to transform a healthcare system from one that treats illness to one that delivers health and wellness, improving healthcare outcomes at the most cost-effective price for patients and taxpayers, says Susan DeVore, Premier president and CEO.
Aurora Health Care in Milwaukee joined the collaborative in August. The 13-hospital system says it is committed to creating ACOs in its markets and accepting accountability for the care delivered to patients by improving care coordination, efficiency, quality, and patient satisfaction.
"There's no question that meeting the demands of healthcare reform will require providers to assume greater accountability for community health," says Nick Turkal, MD, president and chief executive officer for Aurora Health Care. "Keeping people healthy is the best way for health systems to add real value, control healthcare costs, and increase overall satisfaction. We truly believe that ACOs are the future."
That future will include a number of components, from patient-centered health homes to physician compensation models that reward care coordination, efficiency, and productivity. Among the organization's goals: to build integrated relationships with specialists, ancillary providers, and hospitals; to negotiate provider-payer partnerships and reimbursement models that incent improved outcomes and reward value over volume; and to create a population health information infrastructure, including health information exchanges, to enable care coordination across provider networks.