A recent Health Affairs article highlighted the need for data and analytical capabilities in the new group of ACOs who were recently announced. In “Congratulations … And Now The Real Work On ACOs Begins” the article states:
Successful ACOs will need CMS to provide usable data on a timely basis for essential tasks such as identifying attributed beneficiaries, tracking beneficiary utilization with both ACO and non-ACO providers, and reporting financial performance against budget targets. Reporting these data to several hundred ACOs for several million beneficiaries with minimal time lags and in a usable format involves CMS undertaking new tasks on a rather large scale.
Successful ACOs will have the capacity to generate and analyze meaningful reports, incorporating CMS data as well as data the ACO and its providers may generate directly (such as lab values or clinical information drawn from electronic medical records). The reports will provide valuable information allowing ACOs to track performance and identify areas for improvement. ACO systems and leadership will need to translate the information into specific actions targeted to improve performance and correct weaknesses.
After working with the CMS bundled payment since its release in February (and after loading and processing about 1.5 terabytes of that data), we can attest to its importance to analytics, but also to the challenges in transforming it into usable data. The sheer magnitude of the data eclipses the ability of many provider organizations to analyze it, and computing many of the important metrics (such as HCC risk adjusters) can be complex. In addition, the integration of the CMS data with in-house data as described in the article can be frustrating and time-consuming. Yet successful implementation of these steps will be critical to an ACO’s success.
Our white paper on Analytics for ACOs highlights our approach to this challenge and may be helpful in structuring an approach to data and analytics for ACOs. Those organizations should start early to evaluate, consolidate and begin analyses of data from internal sources. Provider groups who have participated in the Bundled Payment for Care Improvement initiative may have a head start on working with CMS data which may be provided in a similar format. But all ACOs will need to develop these analytical capabilities to be successful under an ACO structure.