10. Failure to recognize that everything is interrelated.
It's almost a domino effect. Overestimating the ability to manage risk will be exacerbated by the failure to implement EHRs, which will limit the ability to develop and report performance measures. That could make it more difficult to balance the interests among hospitals and physicians, which could lead to a failure to engage patients and a difficulty in developing contractual relationships with cost-effective specialists. And so on and so on.
That could mean your ACO would fail to reduce preventable hospital readmissions, eliminate admissions for asthma and diabetes, reduce inappropriate emergency department use, or improve the overall patient experience of care. And that could mean no shared savings.
What needs to happen, says Shortell, is that potential ACOs need to develop a strategy to address these possible mistakes. The best way is to develop a system of rapid feedback so that performance can be corrected along the way well before mistakes begin to affect the entire organization.
The key he says is to keep moving forward. "This isn't an overnight process. We're probably 10 years away from seeing a marked difference in how healthcare is delivered. This is just the beginning."