Johns Hopkins Study Charts Path for Successful Academic ACOs

Newswise — Strong leadership, reliable health care coordination and first-rate information technology are key for academic medical centers seeking to establish successful accountable care organizations, according to a Johns Hopkins study published in the journal Academic Medicine this week.

Led by Scott Berkowitz, medical director for accountable care for Johns Hopkins Medicine and assistant professor at the Johns Hopkins University School of Medicine, the study looked at the nation’s first 253 Medicare accountable care organizations (ACOs), paying particular attention to the 20 percent established at academic medical centers (AMCs).

Established with the Affordable Care Act, ACOs include provider groups that are accountable for the quality, cost and overall care for a population of patients. Medicare ACOs that meet certain quality and cost-savings targets are eligible for shared savings, with some early ACOs generating savings that totaled as much as $88 million. AMCs, comprised of teaching hospitals and medical schools, can be good ACO candidates as long as leaders pay close attention to quality and cost-control opportunities, as well as risks associated with caring for large numbers of patients.

Berkowitz and co-author Jennifer Pahira write that, while the first wave of ACOs are generating data, there isn’t yet a roadmap for AMC/ACO success. Using lessons learned from the nation’s first ACOs, Berkowitz and Pahira identify the key areas that academic institutions must address when establishing new ACOs.

The authors found that, when establishing an ACO, AMCs first need strong leadership and a commitment to invest in organizational structures and governance to support ACO success. Berkowitz and Pahira say leadership needs to involve both primary care and specialty providers in planning and operations.

“It’s important for academic medical centers to use their resources wisely when making the transition,” Berkowitz says. “Effective ACOs use strategies that align quality and costs from the start.”

Information technology, according to the study, can also spell success or failure for new ACOs. “There has to be an electronic medical record system robust enough to analyze and assess quality and safety issues,” Berkowitz says. “It’s important to quickly identify areas where changes are needed.”

The coordination of care across care teams, from inpatient to outpatient, is a third success factor, according to the study. Such coordination, says Berkowitz, requires thorough communications with patients and their families, as well as partnerships with local communities.

In January 2014, Johns Hopkins Medicine was accepted by the U.S. Centers for Medicare & Medicaid Services as an ACO. Led by Berkowitz, the Johns Hopkins Medicine Alliance for Patients (JMAP) includes more than 2,000 medical providers offering high-quality care and services to more than 35,000 Medicare patients across Maryland and Washington, D.C. More information on JMAP can be found at http://www.hopkinsmedicine.org/alliance_patients/index.html.

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About Johns Hopkins MedicineJohns Hopkins Medicine (JHM), headquartered in Baltimore, Maryland, is a $6.7 billion integrated global health enterprise and one of the leading academic health care systems in the United States. JHM unites physicians and scientists of the Johns Hopkins University School of Medicine with the organizations, health professionals and facilities of The Johns Hopkins Hospital and Health System. JHM's vision, “Together, we will deliver the promise of medicine,” is supported by its mission to improve the health of the community and the world by setting the standard of excellence in medical education, research and clinical care. Diverse and inclusive, JHM educates medical students, scientists, health care professionals and the public; conducts biomedical research; and provides patient-centered medicine to prevent, diagnose and treat human illness. JHM operates six academic and community hospitals, four suburban health care and surgery centers, and more than 35 Johns Hopkins Community Physicians sites. The Johns Hopkins Hospital, opened in 1889, was ranked number one in the nation for 21 years in a row by U.S. News & World Report. For more information about Johns Hopkins Medicine, its research, education and clinical programs, and for the latest health, science and research news, visit www.hopkinsmedicine.org.