Crowded Plates: For CIOs, Policy Mandates are Piling Up

While Marx’s Texas Health Resources pulled out of the CMS Pioneer ACO to avoid paying a penalty, he says the organization is focusing on it and pursuing other arrangements. Halamka says the focus on ACO creation is important because not only does it relate to Medicare reimbursement, but private insurers are moving from fee-for-service contracts to wellness, pay-for-performance measures.

It might not be that easy though, says Branzell. The clinical side of ACO formation, at-risk contracting, and other long-term efforts in this vein are often directly at odds in terms of resources and requirements with optimization on the current platform within the current payment system. “Those two are constantly butting heads,” he says.

What’s clear, if CIOs are able to agree on one thing, it’s the fact that each policy issue presents a set of specific challenges, which sometimes interfere. Which one should take the highest precedence? Well, that’s where the answers differ (see sidebar).

For John Halamka, M.D., there is something he advises every CIO to do every so often to counter the stresses and pressures of this ongoing reality. Shovel manure.

“I own a farm, so at the end of the day of complex policy and technology activities I can go shovel manure. My advice to every CIO is make sure you have whatever your equivalent is of shoveling manure,” he says.

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