California Health eQuality has created a series of webinars highlighting innovations in health information exchange in California.
“In rural areas, the problem with organizing an ACO is that it’s too expensive [to start up an ACO], and there’s not enough scale to do it,” said Lynn Barr, executive director of the National Rural ACO.
“And there are beneficiary assignment issues. With an ACO generally you have to have a service area of 50,000 patients,” but that number’s higher in rural areas because of the high rate of Medi-Cal beneficiaries, Barr said. “You would need about 200,000 total lives” because of the Medi-Cal mix in rural areas, Barr said.
One solution, Barr said, is to create a national ACO. “The idea is to create economies of scale to lower costs and to gain enough beneficiaries with a rural-focused program. We’ve come up with a program that really works for rural communities.”
The webinar series examines HIE efforts in five specific topic areas:
- Innovations in data analytics, looking at the National Rural ACO;
- Innovations in HIE for special populations, focusing on foster care information;
- Innovations in patient process, focusing on the Blue Button campaign, a national effort led by federal agencies to let patients view, compile and download personal health records online.
- Findings from CHeQ’s HIE survey of community clinics in California; and
- Innovations in HIE for behavioral health.
Barr said quality is the focus of any ACO, especially in a rural setting. “If you provide good-quality care, Medi-Cal will share 50 cents on the dollar of any savings,” Barr said. Even if changes in practice result in relatively small changes in quality scores, that can add up quickly, she said.
Any shared savings, though, depends on quality improvements in four areas, she said: patient satisfaction; preventive health; outcomes data on at-risk populations; and better care coordination and patient safety.
The key to ACO success is health information success, according to Barr. “For any ACO to succeed, you need real time data,” she said.
The next four HIE webinars will be archived and available soon, CHeQ officials said.