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You are reading this article and November 2, elections are over. But healthcare reform is not. Most doubt healthcare reform will be overturned, and there may be parts of it that will change, but as I tell others, prepare as if nothing changes. Take the time line showing the different years and issues and plan accordingly. I will also be back from a national board meeting of the Medical Group Management Association and then national conference. In the December issue of Memphis Medical News I will share some take-aways from both the board meeting and the conference with you.

The two issues I will talk about in this edition are Electronic Health Records and Accountable Care Organizations.

“Meaningful Use” has been defined and EHR vendors are working to comply. I have been talking with different groups and expressing my thoughts and concerns as of this date. Groups are now looking to make decisions and one of my major concerns is—can vendors deliver a quality product (training, installation and support) in a timely manner? I have always suggested that groups have a Health IT Action Plan. Look at HIT holistically and not just for the incentives. Determine Medicare and Medicaid bonuses and incentive payments that may be available to you. Develop an IT plan to maximize benefits and minimize burdens.

Monitor program updates, RECs through: www.mgma.com and http://healthit.hhs.gov/. Monitor your state and commercial health plan activities regarding incentive programs. Also monitor and take advantage of administrative simplification opportunities. Robert Tennant, senior policy advisor for MGMA Government Affairs expressed concerns that many vendors will fall short in delivering a quality product. Many practices are moving forward and the major concern is—can the vendor deliver? Demand for time and a vendor having the resources to insure a timely and successful installation is a tremendous concern.
 
Lately, I have seen where some proposals by vendors are questionable as to their capabilities. I believe the REC, which is located here in Memphis, is invaluable in helping with this. I am a proponent in local support and also in a single source; i.e. software, hardware, and support.

Virtually all healthcare reform proposals call for increased provider involvement in a more coordinated and cost effective system through accountable care organizations (ACOs). The emphasis will be on providers focusing on care management and delivery to defined populations, replacing today’s focus on patient volume. Physician-led organizations responsible for care delivery and coordination, data and information, technology infrastructure and the use of evidence-based medicine and performance are key attributes for what we know now of as ACOs. (Just as in the integrated delivery system days; if you have seen one you have seen one).

Payers will likely drive quality-based systems, but it will be providers who organize and will create and provide the structures. This author is a proponent of physician/hospital-driven initiatives and not one of hospital/insurance initiatives. Carilion Clinic in Roanoke, Virginia is a very good example of an ACO Pilot Project (MGMA Connection). An important challenge for the physician medical community, practice administrators and other advisors is the best way for you to participate.

Be leery of organizations which propose to be ACOs when the final product is yet to be determined. Do not be persuaded by fast talking executives making you believe they have found the silver bullet. On Saturday, October 30, the Memphis Medical Society sponsored a Payment Reform Symposium with various leaders and healthcare constituents. The writing of this article was the middle of October, so in my December article I will share with you more about this Symposium, and also the information gathered at the MGMA board meeting and national conference. There is never a dull moment with being informed and engaging in reform.

Bill Appling, MBA, FACMPE, is president of Watkins Uiberall Health Care Consulting. He has faculty appointments at the University of Memphis in the Fogelman College of Economics and Business, where he teaches in the Masters of Health Care Administration program.

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