Any physician group thinking about creating an Accountable Care Organization should take a few pointers from this article from the International Journal for Quality in Healthcare. In 2005, they published a thought-provoking 10-page article titled " A performance assessment framework for hospitals: the WHO regional office for Europe PATH Project.  Accountable Care Organizations (ACOs) seeking to differentiate themselves from those who simply organize to the minimum standards set forth by the Center for Medicare and Medicaid Services (CMS) would be wise to review and discuss this framework and integrate the six dimensions into their organizational design, quality goals, benchmarking metrics and organizational culture of accountability.

The World Health Organization (WHO) Regional Office for Europe launched in 2003 a project aiming to develop and disseminate a flexible and comprehensive tool for the assessment of hospital performance and referred to as the performance assessment tool for quality improvement in hospitals (PATH). This project aims at supporting hospitals in assessing their performance, questioning their own results, and translating them into actions for improvement, by providing hospitals with tools for performance assessment and by enabling collegial support and networking among participating hospitals.

Through the evaluation, six dimensions were identified for assessing hospital performance: clinical effectiveness, safety, patient centredness, production efficiency, staff orientation and responsive governance. The following outcomes were achieved: (i) definition of the concepts and identification of key dimensions of hospital performance; (ii) design of the architecture of PATH to enhance evidence-based management and quality improvement through performance assessment; (iii) selection of a core and a tailored set of performance indicators with detailed operational definitions; (iv) identification of trade-offs between indicators; (v) elaboration of descriptive sheets for each indicator to support hospitals in interpreting their results; (vi) design of a balanced dashboard; and (vii) strategies for implementation of the PATH framework.  The program was a success and was extended to include 8 different countries within Europe.

AskMariaTodd™ experts can help you build your Accountable Care Organization for success with capitated or bundled reimbursement, and patient-centered, safe, high quality care.  Call us today if you'd like to discuss organizational development, capitation, strategy, or contracting techniques for ACOs.

About the Author:

Maria K Todd, MHA, PhD is known around the world for her expertise and generosity in sharing ideas, techniques and practical tools with her colleagues in the industry. She is a leading health care industry consultant and described by clients and peers as a visionary and thought leader. Statistically, she is the leading trainer in managed care contracting worldwide.  Since 1989, she has lectured professionally through colleges, universities, seminar companies, publishers and non-profit professional associations as well as on-site private training classes for hospitals, medical groups, offshore revenue cycle business process organizations and pharmaceutical and medical device manufacturers. In total she has delivered more than 2600 managed care training classes and seminars to over 53,000 attendees and participants.  Every month the number grows higher and higher!

Conflict Disclosure: The author is a professional consultant and derives a substantial percentage of her income reviewing managed care agreements and advising hospitals, physicians and others on matters regarding managed care and contracted reimbursement. The author previously worked for a Health Plan in provider relations as a contract negotiator. The author has no other conflicts to declare. This disclosure accurate as of November 5, 2008.

Notice: Please remember that the opinions, and information contained in this document is that of the individual author.  These materials (1) do not constitute legal advice; (2) do not form the basis for the creation of any relationship; and (3) should not be relied upon without seeking specific legal advice with respect to the particular facts and current state of the law applicable to any situation requiring legal advice. These materials may only be reproduced with the prior written consent of Maria Todd.  These materials are provided with the understanding that the author is not rendering legal, accounting, or other professional advice or opinions on specific facts or matters, and, accordingly, such entities assume no liability whatsoever in connection with their use.

You can learn more about managed care contracting in Maria's latest book,The Managed Care Contracting Handbook, 2nd Edition (2009)

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