Driving population health through accountable care organizations.

Accountable care organizations, scheduled to become part of the Medicare program under the Affordable Care Act, have been promoted as a way to improve health care quality, reduce growth in costs, and increase patients' satisfaction. It is unclear how these organizations will develop. Yet in principle they will have to meet quality metrics, adopt improved care processes, assume risk, and provide incentives for population health and wellness. These capabilities represent a radical departure from today's health delivery system. In May 2010 the Premier healthcare alliance formed the Accountable Care Implementation Collaborative, which consists of health systems that seek to pursue accountability by forming partnerships with private payers to evolve from fee-for-service payment models to new, value-driven models. This article describes how participants in the collaborative are building models and developing best practices that can inform the implementation of accountable care organizations as well as public policies.

Top 10 things hospitals need to know about health reform ... but were afraid to ask.

The top 10 critical areas of reform that are of concern to hospitals include: Understand financial implications. Do more with less. Optimize revenue cycle, labor productivity, and supply chain. Move patients from self-pay to coverage. Make quality job No.1. Prepare for transparency. Deal with infections. Implement physician alignment. Move from volume to value: accountable care organizations. Obtain HITECH funding.

Lessons premier hospitals learned about implementing electronic health records.

Implementing health information technology (IT) is a major strategic objective for providers. To pinpoint considerations that tie to success, the Premier health care alliance surveyed hospitals to develop an electronic health record best-practices library. Compiled from diverse health care organizations, the library outlines considerations to support "meaningful use" in the areas of computerized physician order entry, medication management, clinical documentation, reporting of measures, privacy, information exchange, management of populations' health, and personal health records. Best practices also uncovered strategies for securing executive leadership, culture change, communication, and support for clinicians. This paper summarizes lessons from the library, providing recommendations to speed up health IT implementation.

Results from the first 4 years of pay for performance.

Some of the lessons hospitals that have participated in the Hospital Quality Incentive Demonstration project have learned include: the need to tie in quality-of-care initiatives to the organization's strategic plan and to incentive plans for all employees, from executives on down; the value in allowing hospital physicians to "own" quality improvement initiatives; the importance of making results of the initiative available to all staff; the benefit of creating best-practice teams to address improvements in specific clinical areas.

The value of value-based purchasing.

In the first four years of the Hospital Quality Incentive Demonstration (HQID) project operated by the Centers for Medicare & Medicaid Improvement (CMS) and Premier, Inc., HQID hospitals improved their composite quality scores by 17.2 percent across five clinical areas. If every hospital were able to replicate this level of performance, an estimated $4.5 billion and 70,000 lives would be saved each year, according to CMS and Premier.