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HIEs and ACOs: What's the Connection?

February 1, 2011
by David Raths
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With sustainability the struggle for HIEs, now is the time for them to prove their value as ACO data backbones

Whatever shape accountable care organizations (ACOs) take and no matter who end up running them, it is clear they will need to be adept at sharing patient data across care settings. As several panelists at the recent eHealth Initiative annual meeting in Washington, D.C., noted, that is exactly what health information exchanges are set up to do. With so many HIEs struggling to find a sustainable business model, they argue that now is the time for them to prove their value as ACO data backbones.

John Evans, president of S2A Consulting, who has assisted five states with their health IT plans, said HIE groups should be aggressive now in figuring out what they can do to support ACOs. “In striving to reduce the cost of care and share in a percentage of the savings, ACOs are all about the data,” he said. “Therein lies the opportunity for HIEs. They can become a core element of ACOs, but there is not a lot of time. There is an enormous opportunity that is going to move on. But it will be a travesty if the ACOs have to replicate what HIEs do to get ready for 2012.”

Speaking on the same panel with Evans, Liza Fox-Wylie, policy director for the Colorado Regional Health Information Organization (CORHIO), said her group might provide one example of how HIEs can support ACOs.

Beginning this spring, the state’s Accountable Care Collaborative program expects to enroll 60,000 Medicaid clients in four regional ACO pilots. The goal is to control costs by integrating the principles of a patient-centered medical home model. CORHIO is building out its infrastructure to provide Medicaid claims-based data and clinical information to the providers in those ACOs. “We are working to get those providers more robust information — information that is immediately actionable when patient comes in for a visit,” Fox-Wylie said. “We are using HIE as a tool to advance ACOs.”

Will HIEs and ACOs form symbiotic relationships? Can HIEs provide the data and analytics that create the feedback loop ACOs will need to improve their efficiencies? Is the ACO movement the potential source of ongoing funding HIEs have been seeking? What do you think?


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