OIG: ACOs Need to Get Better at Health IT

Technology is key to helping accountable care organizations (ACOs) coordinate better patient care — yet ACOs still aren’t leveraging health IT to its full potential.

That’s according to a report from the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG).

OIG officials interviewed providers and staff from six different ACOs to reach their health IT conclusion. Participating organizations were chosen based on their performance, geographic variation and recommendations from the Centers for Medicare & Medicaid (CMS) and the Office of the National Coordinator for Health IT (ONC). Additionally, all six ACOs had three or more years of experience.

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“The six accountable care organizations we visited have used health IT tools to better coordinate care for their patients,” the report says. “However, the promise of seamless integration and coordination across providers and care settings has not yet been realized.”

For ACOs to achieve what they’re meant to, exemplary integration is vital.

An ACO is a network of health care providers — including home health companies — that work together to coordinate improved care for patients at a lower cost to Medicare.

If they succeed, they’re rewarded by being paid a portion of the savings they achieved. On the other hand, if they don’t hit the targets set for them, they’re often financially penalized.

ACOs that mandated all providers involved use one electronic health record (EHR) system were able to coordinate care most seamlessly, according to the report. Those whose providers used different EHRs faced greater interoperability challenges, making it harder to seamlessly coordinate care for patients.

“ACOs using multiple EHR systems had to rely on other means to share data between providers, such as phone calls and faxes,” according to the OIG report.

Other IT challenges outlined include physician burnout due to the workload of managing EHRs, incomplete electronic health information exchange data and the sparse or infrequent use of analytics to customize patient care.

Additionally few ACOs offer patients health IT tools, other than EHR portals.

Home health providers have long been interested in ACO involvement, hoping to be recognized and financially rewarded for what they do already — reduce costs and hospitalizations.

But getting chosen to participate is easier said than done, unless you’re a post-acute powerhouse like LHC Group (Nasdaq: LHCG).

When the Lafayette, Louisiana-based company acquired Almost Family in 2018, Imperium Health Management — one of the largest ACO management companies in the country — came as part of the deal.

As a result, LHC Group doubled the number of Medicare ACOs under company management in 2018 to 30 covering 460,000 Medicare lives. That’s compared to 16 ACOs covering 140,000 Medicare lives in 2017, according to company SEC filings.

OIG’s report suggests home health providers with strong health IT capabilities may have an edge in building ACO relationships moving forward, especially if that’s a note federal watchdogs continue to harp on.

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