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Challenges posed by accountable care drive new data uses

Challenges posed by accountable care drive new data uses

Accountable care organizations are gaining prominence as one of the nation’s leading approaches for making the shift to value-based care. Providers in these ACOs are facing a variety of business challenges, including gathering and using data to improve care.

In many cases, ACOs are finding they need to incorporate data from a variety of sources, placing new importance on activities such as master data management, analytics and population health management applications.

ACO data requirements are driving IT vendors to tweak offerings to make them appropriate for their needs.

“To be successful, ACOs need to bring data together from different systems—payers and providers,” says Pete Hess, vice president and chief data architect at Health Catalyst, a data warehousing, analytics and outcomes improvement company.

According to Hess, one of the keys for ACO success is the ability to gather the data and combine it into a data warehouse that can direct overall efforts. “Master data management (MDM) tools are critical to the success of these efforts.”

“Some MDM tool providers focus on patient identity resolution—the classic (enterprise master patient identifier) problem space—while others focus exclusively on reference data, which is the space of terminology management tools,” Hess says.

Hess sees MDM evolving to meet the evolving needs of value-based care. “Value-based care requires organizations to be more collaborative than ever before, which means data must be shared,” Hess says. “Shared data is always going to have discrepancies—MDM tools can help manage those discrepancies.”

John-KellyAside from data helping ACOs to accomplish their mission, data can also be used to help providers get a vision of their potential future in an ACO. John Kelly, principal business advisor for Edifecs, says data can be used to see where their risks would lie, if a provider organization joined an ACO. Organizations are having to sign on to an ACO “with a blindfold on,” he says, and “that’s why there are a lot of horror stories going on.”

Since members of an ACO rise or fall together based on their success to control costs and improve outcomes across the continuum of care, it behooves them to see the data horizontally ahead of time. “Risk-takers need to be able to look at all the data,” he says.

This requires the ability to test and manage thousands of data-sharing relationships. The data is likened to a supply chain, Kelly says. “The irony is: every other industry has been doing this. It’s about supply chain integration–all those things that other industries have already nailed.”

Read views of other experts in full. Published by Healthdatamanagement.com 


Edifecs delivers the industry’s premier healthcare information technology partnership platform. Since 1996, Edifecs software solutions have helped healthcare providers, insurers, pharmacy benefit management companies, and other trading partners trim waste, reduce costs and increase revenues. More than 350 healthcare customers today use Edifecs solutions to simplify and unify financial, clinical and administrative transactions. In addition, Edifecs develops supply chain management solutions to support worldwide customers in non-healthcare industry segments. Edifecs is based in Bellevue, WA, with operations internationally.