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DiagnosisOne Applauds Massachusetts’s Commitment to Improving Quality & Lowering Costs with ACOs

March 3, 2011

by Mansoor Khan, Sc.D.

On Feb 17, 2011, Governor Duval Patrick of Massachusetts filed “An Act Improving the Quality of Health Care and Controlling Costs by Reforming Health Systems and Payments.”  This bill will allow Massachusetts to lead the nation in employing the Accountable Care Organization model for the provision of health care. 

This payment reform initiative builds on the state’s historic success in expanding health insurance coverage to 98% of its population. With so much of the state now covered, the next challenge is to reduce its cost.  Under the proposed legislation, physicians, hospitals and other care providers will be paid for the quality of care they provide and the overall health of the population they serve, rather than simply the amount of care services they deliver. 

Specifically, under the filed legislation, Massachusetts will:

  • Set aggressive targets to reduce fee-for-service reimbursement in the state, substituting it with an integrated care organization model, more typically referred to as Accountable Care Organizations (ACOs); 
  • Implement several key infrastructure elements to support the creation of ACOs,  including standards setting, certification of ACOs by the Department of Insurance, issue quality reporting requirements; and
  • Initiate several measures to reform medical malpractice issues and encourage care delivery innovation.

For the last several years, DiagnosisOne has been working with providers and insurers in Massachusetts to apply clinical decision support technology to reduce costs and improve outcomes.  In one study of 77,000 patients in the Commonwealth, DiagnosisOne uncovered an achievable annual savings of $31 million to $61 million, or $400 to $800 per patient per year. Under the proposed Accountable Care Organization model, provider organizations armed with this technology will be organized to capture savings like this. 

To give hospitals and Independent Physician Associations (IPAs) a clear roadmap on what is required to excel under this new reimbursement paradigm, DiagnosisOne just published Clinical IT Requirements for ACOs, Enabling Effective Patient & Population Management.  We continue to innovate with our hospital, payor and EMR clients on new methods to ensure each care encounter is as informed as possible, and each health system leader has the information required to design effective health improvement strategies. As ACO-like models take hold in the market, providers with these capabilities will be uniquely positioned to reap the financial windfalls associated with consistently providing evidence-driven, informed care.

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