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Accountable Care Organizations and Your Workforce

May 19, 2011

Every day, we are inundated with news about Accountable Care Organizations (ACOs).  The ACO concept is at the center of the Patient Protection and Affordable Care Act.  It is the primary method of coordinating services, improving quality and reducing costs.

Berwick touts ACOs in an exclusive online commentary.

An excerpt: The idea of the ACO is to encourage and support physicians, hospitals and other providers to lower costs by providing better quality care, and to reward them for success by allowing them toshare in the resulting savings. ACOs are part of an important agenda of change: to shift American healthcare from a system based on the volume of care (the more you do, the more you get paid) to one based on the results of care (the better you do for patients, the more you get paid).

The focus, however, continues to be on rules and structure.  Who can establish an ACO?  What about Stark, Anti-kickback and Anti-Trust rules?  How will we measure quality?

Summary of Proposed Rules on Accountable Care Organizations: http://thehealthcareblog.com/blog/2011/04/18/summary-of-cms-proposed-rule-on-accountable-care-organizations/

CMS announces three ACO initiatives

The reality is that forming an ACO – putting the legal entity in place, does not somehow change the coordination of care, the quality of care, the patient experience, or reduce cost by even the first dollar.  In fact, millions are being spent to form these complex organizations, or to align provider-resources in preparation for the new world of ACOs.

On the ground, some things don’t change.  We must improve key quality metrics and patient satisfaction scores, while reducing costs.  The difference is that the ACO concept assumes a new, higher level of coordination and collaboration.  What does this mean to HR?  More than ever, we need a workforce with the skills to function in this new world.

Are your current systems and processes effective at identifying, selecting and developing leaders, managers, providers and front line staff who are adaptable to change, and able to collaborate and innovate?  The traditional healthcare approach has emphasized clinical and technical skills.  In fact, in some professions, an isolated, highly autonomous, expert culture has been encouraged!

Change is coming quickly.  Have you defined the behavioral competencies required to survive?  Do you have valid, useful selection processes in place to identify the right candidates?  Are you using these tools to make promotion decisions?  Given where we need to be, how confident are you that every hiring and promotion decision is being made using the best information available and will move you in the right direction?

For more information, see Select International’s White Paper on Transforming the Healthcare Workforce.

Reducing Turnover in Healthcare

Bryan Warren Bryan Warren was the former Director of Healthcare Solutions at PSI. He was responsible for developing and promoting tools and services designed specifically for the unique challenges faced by healthcare organizations.