“We view value-based purchasing as an important step to revamping how care and services are paid for, moving increasingly toward rewarding better value, outcomes and innovations instead of merely volume,” the rule makers said. “We seek to evolve a focused core-set of measures appropriate to each specific provider category that reflects the level of care and the most important areas of service and measures for that provider. The collection of information should minimize the burden on providers to the extent possible. As part of that effort, we will continuously seek to align our measures with the adoption of meaningful use standards for health information technology.”
Rule makers said that health teams working under the ACO regs must support patient-centered medical homes that provide care using “evidence-informed medicine” and “appropriate use of health information technology” among other requirements.
Elsewhere, in explaining value-based purchasing initiatives, the rule said the industry must move “as quickly as possible to the use of outcome and patient experience measures” that are adjusted for risk, population and provider characteristics, calculations that would be infeasible in a healthcare organization without robust health IT capabilities.
Veteran physician informaticist Dr. Scott Weingarten, a co-founder and CEO of Zynx, a developer of clinical decision support tools and resources, now a division of Hearst Corp., said that to be successful as an ACO, “You're going to need to have a very strong information technology infrastructure and clinical decision support capabilities within your organization.”
But Weingarten said there is only so much overlap between organizations being able to meet meaningful use targets and those seeking to operate on the higher plain of an ACO.
“There seem to be a lot of things you need to do to become an ACO that are not directly related to meaningful use requirements,” he said.
“There is convergence between the draft Stage 2 and Stage 3 (meaningful use criteria now up for public comment) around clinical decision support,” Weingarten said, and the ACO proposed rule that “requires the use of evidence-based clinical decision support.
“I think they got that right,” Weingarten said.