In addition to our own research and experience with Accountable Care Organizations, we have been connecting with other healthcare marketers who deal with ACOs. Earlier we spoke with Paul Szablowski from Dignity Health in Arizona and learned about the results they’ve seen since operating under a patient centered program.

 

Jill McDonald, APR

Vice President, Communication and Market Development

Q: Where are you in the ACO journey?

A: Eastern Maine Health Systems is one of the 32 organizations invited to become a Pioneer ACO, part of the Affordable Care Act. Each of our seven hospitals will be identifying appropriate patient participants over the coming months (three hospitals already have engaged in the process, four more to follow) who fit the criteria for care management. In addition, we are developing an ACO product for our self-insurance plan for employees as well. That plan covers approximately 8,000 people and their dependents.

Q: What is your patient base?

A: Our primary patient base for the ACO is Medicare patients because that’s the population that Pioneer targets, but it is growing quickly. There are some big employers that are wanting us to take on their employees, and we are doing it with our own employees, too.

Q: What’s worked well so far?

A: In our experience the best way to help patients and even caregivers to understand the value of this approach is to feature patient stories. Because we have been Patient Centered Medical Homes for five years now, and we’re beginning to wrap up a three year Beacon Community Grant, we are able to share actual stories of real patients and the dramatic changes in their lives that this more aggressive management of chronic disease has produced. The telling of the stories takes all the theory out and makes it real. The patients’ thoughts, straight from their own mouths is priceless. From a layman’s point of view the story about the difference between Beacon and ACO is about the payment structure. The mechanics of patient management seem very similar, so far. Accountable Care is not rocket science, and patients can tell the story that it works. Once you hear those stories, the benefits become clear and the model’s not mysterious or scary to patient or providers.

Q: How did/do you communicate with patient audiences?

A: Our chief medical officer framed it like this: “To understand what an ACO is, it’s important to first understand what it isn’t. It’s not a health maintenance organization (HMO), and it doesn’t affect people’s benefits. ACOs put the doctor in charge of patient care, not insurance companies.” And we also like to say “it isn’t about healthcare, it’s about health.”

We are very cautious about calling the program “ACO” because it sounds bureaucratic, governmental and suspicious. Defining it, by calling it something that is meaningful to patients and doesn’t sound like jargon is a better idea. It shouldn’t sound like the flavor of the week…but rather the new, different way we will be caring for you going forward. We try to position it as joining a national effort that rewards doctors for keeping their patients healthy and happy, rather than waiting until they’re sick.

Q: What’s next?

A: We’ll be including our Critical Care Hospitals in the system in the next few months, and beginning to include partners that are outside our healthcare system as well. So far, we have announced the inclusion of the local Federally Qualified Health Center, and are working to develop an agreement with another local hospital that’s not in our system. Our experience with the Beacon Community really has set up the trust relationships with outside organizations that will help us make the ACO and these next steps much more manageable. It really is a whole new world, focused on collaboration—across the healthcare community and also with the patients. And intuitively it just feels like the right care—better care.

 

If you’re free October 25th at 9:00AM, Jill is giving presenting a webinar on the subject of Accountable Care Organizations. Sign up and learn more about the event at the NESHCo website.

How do Jill’s ACO experiences compare to yours? Any top takeaways for your planning process?

For more on ACOs, check out the rest of our series:

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