Integrating Independent Physicians into an Accountable Care Organization

Keywords: Advocate Physician Partners, Advocate Health Care, accountable care organizations, asthma, care coordination, care management, Illinois, intensive care, independent physician associations, performance improvement, prevention, physician and hospital collaboration, value

Advocate Physician Partners, a joint venture representing approximately 3,500 physicians serving patients in Illinois, could serve as a model for a new kind of ACO. Advocate Physician Partners is affiliated with Advocate Health Care, a not-for-profit faith-based health system in northern and central Illinois. By organizing physicians into partnerships with hospitals to improve care and be held accountable for the results, Advocate Physician Partners has addressed the most significant barriers to creating an effective ACO, and has also has made impressive strides in quality and outcomes.


A Model for Integrating Independent Physicians into Accountable Care Organizations

The online version of this article by Mark C. Shields, Pankaj H. Patel, Martin Manning, and Lee Sacks is available at:

http://content.healthaffairs.org/content/30/1/161.full.html

The Affordable Care Act encourages the formation of accountable care organizations (ACO) as a new part of Medicare. At this point, however, it is unclear precisely how these ACOs will be structured. Although large integrated care systems that directly employ physicians may be most likely to evolve into ACOs, few of these truly integrated systems exist in the United States.

Advocate Physician Partners, a joint venture representing approximately 3,500 independent physicians serving patients in Illinois, could serve as a model for a new kind of ACO. Advocate Physician Partners is affiliated with Advocate Health Care, a not-for-profit faith-based health system in northern and central Illinois. For more than fifteen years, the partnership between physicians and Advocate has performed care management and managed care contracting. By organizing physicians into partnerships with hospitals to improve care and be held accountable for the results, Advocate Physician Partners has addressed the most significant barriers to creating an effective ACO. It has also has made impressive strides in quality and outcomes.

Advocate Health Care hospitals invested more than $10 million in the technology of a centralized command center for all 250 adult intensive care beds in eight of its ten acute care hospitals. Staffed around the clock by board-certified intensivists, the initiative allows these specialists to make immediate changes in patients’ treatment based their condition, without waiting for the approval of attending physicians. In this way, new drugs, procedures, or therapies can be applied immediately, without delays. As a result, mortality for adult intensive care patients has decreased steadily since the program was implemented in 2003.

As part of a comprehensive program for care of asthma patients, the partnership has implemented standardized asthma action plans for home management, individualized for specific patients. In 2009, the partnership implemented action plans for 83 percent of its asthma patients. This number was three times greater than the national average, according to a study that showed only 26 percent of controlled asthma patients and 35 percent of uncontrolled asthma patients received such a plan from their physicians. And the partnership’s results typically exceed the National Committee for Quality Assurance’s measures for management of blood sugar, cholesterol, and blood pressure.

FOR MORE INFORMATION:

Nancy Taylor
Executive Director
Council of Accountable Physician Practices
|nancy.taylor@amga-capp.org
www.amga-capp.org

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