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Meaningful Use -Springboard for Accountable Care Organization

In recent times, healthcare in United States has witnessed unparalleled revolution which is led by the government-driven multibillion dollar health reform initiatives. Most of these reforms intend to address the key menaces of US healthcare, which are spiraling healthcare costs, inconsistent healthcare quality and fragmented care delivery. Two such reforms that have grabbed nationwide attention are Meaningful Use and Accountable Care.
These reforms require the healthcare providers to work towards implementation of the electronic medical records and achieve benchmarks of meaningful use of technology, at the same time position themselves to join or form Accountable Care Organizations (ACO). In a shared accountability model like ACO, healthcare stakeholders are collectively responsible for entire continuum of care for beneficiaries with their reimbursements tied to the quality of care outcomes and cost savings. The successful conception and sustenance of this model calls for robust stakeholder collaborations, cross continuum care coordination, performance management and cost reduction strategies. The key to attain and sustain such a regional collaborative initiative would be a shared information infrastructure that presents accurate, complete and timely management and exchange of information.

This vision of shared information infrastructure can be achieved through deploying the right mix of technologies that complement each other and support the healthcare ecosystem. The 'Meaningful Use' mandate is focused towards achieving this through stressing on the adoption of right technologies and using it to derive meaningful outcomes. While addressing the information infrastructure needs, the Meaningful Use mandate also acts as a springboard for smooth transition to ACO model by helping the aspirants reach up to the low hanging fruits. Some of the key strategic quick win areas for ACO aspirants by way of leveraging the MFU program participation are:

Adoption of Electronic Patient records- We see that even stage 1 Meaningful Users of EHR are prepared to enter into Accountable care coalition since they have robust Medical Records sharing infrastructure and established practices of patient engagement.
Better Care coordination - ACO need to effectively address the care coordination needs and regulate the cost of care. EMR adoption addresses this need by providing the well-integrated secure networks for exchanging patient data and performance metrics.
Enhance patient Engagement- MFU  necessitates the inclusion of patient and his family as key stakeholders in the care, promoting providers to open up communication channels with patient and exchange health related information with them. This also forms the key quality goals of ACO.
Improving Quality safety and efficiency - Meaningful Use program drives operational and clinical efficiencies through technology adoption. Quality, safety and efficiency being the key program outcomes of both MFU and ACO programs, it provides a good foundation for ACO.
Performance monitoring- MFU program infrastructure could be effectively leveraged by the ACO model for measuring and reporting clinical outcomes.

It is evident that MFU program allows organizations to baseline their IT infrastructure and the EMR capabilities and reach benchmark levels of technology adoption thus facilitating electronic health information exchange. This would pave way for providers to participate in new delivery models like ACO. The MFU also provides a shared information infrastructure allowing nationwide management and exchange of healthcare data. This clearly point to the applicability of MFU directive towards addressing ACO needs namely robust stakeholder collaborations cross continuum care coordination, performance management and cost reduction strategies.

With MFU directive rendering building blocks for a sustainable and scalable ACO model, there is an opportunity to leverage the congruence symbiotically in achieving the vision of optimized healthcare costs and enhanced clinical quality. The higher momentum and efficiency imparted to the programs by way of this synergy would also positively impact the federal incentives for providers. Since the MFU program kicked off at an earlier stage, there are operational and policy level gaps that need to be narrowed for better alignment with the ACO requirements. The needs of a future state mature ACO model could be addressed through progressive program iterations that are performed by keeping the associated cross program synergies in mind.

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