Exciting Times for Health Care Business Analytics

There really isn’t any better time to be a ‘health care business analytic’ major than right now.  There are exciting times ahead for those of us interested in health care business analytics.  It's the foundation that  fuels Accountable Care Organizations and the opportunities for business process improvement. 

This week’s essay question is:  Should we be excited about the prospects of creating multiple accountable care organizations in the health care delivery system?”  Whether we are excited about accountable care organizations depends on if we

• ·      are health care service consumers
• ·      are health care providers (primary care Dr., specialists, payers)
• ·      even understand what the term means

The term Accountable care organization (ACO) has come about due to recent health reform legislation to address the current issues of our US health care system : the current health care system is not effective, efficient, nor sustainable.  Today’s US health care system overtly rewards overuse and fragmentation of services. (Mark McClellan, 2010)

ACOs are comprised of groups of health care providers who together are held accountable for achieving measurable quality improvements in the health care services that they provide.  The Centers for Medicare and Medicaid believe that these quality improvements, in turn, will reduce the rate of spending growth.

What is an Accountable Care Organization?

According to the authors of this Health Affairs report (Mark McClellan, 2010), in most cases, the public and even the providers do not know what an ACO is. By definition, an accountable care organization is a set of providers, and the types of providers in that organization comprising that ACO is flexible.  But, if any given ACO can demonstrate and show verifiable evidence that their group of health care providers improved the care they provided (through better care coordination and delivery) – that ACO group shall receive a “bonus” from Medicare and Medicaid.  This process improvement initiative in the health care system overall will in turn will slow spending growth and improve the health care process for their patients.

Gathering performance improvement metrics on daily tasks, process improvement,  lowering costs which in turn possibly means working harder for less money.  That is not a happy story for a health care provider.

For the general public, this Accountable Care Organization trend is certainly something to be excited about.  Better care, provided more efficiently, and at a lower cost.  It really cannot get any better than that. 

So, in response to the question “should we be excited about the prospects of creating multiple Accountable Care Organizations in the delivery system?”  The answer is:  It depends on who you are.  For me, the “Health Care Business Analytic” Graduate Student, truly exciting times lay ahead.

Works Cited

Mark McClellan, A. N. (2010). A National Strategy To Put Accountable Care Into Practice. Health Affairs. Health Affairs.

 Health Affairs "A National Strategy To Put Accountable Care Into Practice"