1. ACO Analytics: The good, the bad and the ugly

2. Speaker
Mical DeBrow, PhD RN Director, Health Analytics and Business Intelligence G2 Works

3. Drivers of Healthcare 2015

4. The data avalanche is here…

5. The Goal?
Data Knowledge Action

7. Use a SMARTER Approach Specific Measurable Assignable Realistic
Time-bound
Evaluate
Re-evaluate

8. Analytics and Data are NOT just Cost Centers

9. Do ACOs have you tied up in knots?

10. What is an Accountable Care Organization?

11. Why should you care?

12. What kind of risk are we talking about?

13. How is efficiency measured?

14. Four Domains
Patient/caregiver experience – Consumer Assessment of Healthcare Providers and Systems (CAHPS)
Care coordination and patient safety
At-risk population
Preventive health
Extra slide

15. The Ugly Domains and measures are subject to change annually
30% shift in traditional Medicare to quality/value alternative models (such as ACOs) by the end of 2015
50% shift in traditional Medicare to quality/value alternative models (such as ACOs) by the end of 2018
Even higher percentages through Value-based Purchasing and Hospital Readmission Reduction Programs (85%, by 2015; 90%, by 2018)
Extra slide

16. Thou Shalt Not Boil the Ocean

17. What Should You Be Doing?
Engage with providers and payers
Choose or adapt the vehicle for your ACO
Do you belong to more than one ACO?
Assess your capabilities to access and measure populations and health analytics

18. How Analytics Sustain an ACO
Care coordination
Population health
Decreased costs and increased reimbursements
Patient experience

19. Use analytics to drive the business of healthcare, NOT only report it!

20. The key to unlocking information…

21. Data Governance Data Quality Privacy and Security
Communications and Awareness
Policy and Standards
Technology and Infrastructure
Compliance

22. Other Items to Consider
Population health—what does that really mean?
Decreasing costs, increasing reimbursements
Improving the patient experience

23. Lessons Before You Learn
Build a solid foundation
Integrate ALL data
Ensure that data is validated against known sources
Start with small wins at high levels

24. More Lessons Gain clinical, financial and operational buy-in
Set appropriate expectations
Allocate appropriate funding
Determine the model you can support

25. Ancora imparo: Still, I am Learning
Plan for future process needs
Create enterprise-wide definitions
Don’t bite off more than can be resourced
Involve end-users only when the timing is right

26. Health Analytics Must Continue to Evolve
Retrospective
Concurrent
Predictive
Prescriptive
What’s Next?

27. Things to Think About Is there agreement on what to measure?
Are there realistic goals or targets?
Is an upward or downward trend better?
Is there such a thing as “too good?”
Are there critical thresholds?
Can anything be done to affect the measure?

28. And the Analytics Just Keep Coming
Two-Midnight Rule or Short Stay Admissions
Meaningful Use 3
Recovery Audit Contractor program resumes
Value-based Purchasing (actually, Quality-based Reimbursement)
Hospital Readmission Reduction Program
Patient Safety Indicators (PSI 90)

29. Putting It All Together

30. Questions?

31. Thank You!