Transforming Solo Practices Into Accountable Care Organizations

More and more solo practices are facing a transformation that is neither small nor simple in the current accountable care environment. The transformation will likely require massive organizational changes in order to coordinate care for defined, high-risk populations. A new white paper issued by Frost & Sullivan, titled “The Accountable Care Team: A Guide for Care Delivery Transformation,” suggests that successful models of this change are emerging.

One transformation in particular is noteworthy not only due to its efficacy, but because of its maturity. The paper highlights the work of the IT teams at Providence Health & Services in Oregon, fully eight years before the passing of the Affordable Care Act. Their approach combines an organizational design known as the care team with a software application they developed called CareManager. Using the software application, clinicians at Providence have gone far beyond simple delivery on the synergistic goals defined by the Triple Aim of health care.

The care team, according to authors Greg Caressi and Patrick Riley, is the “fundamental organizational unit that can move an accountable care strategy from theory to practice without the burden of large, upfront capital investments in data management systems and the accompanying overhead.”

The care team is led by the physician, often working in partnership with another physician with shared clinic-based resources, a “teamlet.” Advanced practices have realized further quality and efficiency gains by creating a hub of resources focused on assisting physician-led teamlets in population management and coordination support. Centralized resources in the hub use population health analytics to reach out to patients with care opportunities or to those in need of care coordination.

The authors note that identifying the best way to communicate between the patient, teamlet, and hub is a challenge for organizations. There is a delicate balance between an individualized patient-centered touch and large-scale automated efficiency.

"Transforming a current delivery system into one that implements care teams requires strategic planning and operational insight," said Frost & Sullivan Connected Health Senior Industry Analyst Patrick Riley. "This translates to an analysis of the ways in which the organization is staffed, trained, and prepared to embrace care teams."

A copy of the white paper can be found here.