Looking "outside", seeing the road ahead

Our December 19, 2011 post was entitled, "To understand eye care, look outside!" We talked about the infamous crystal ball, which no one seems to have, and why it's not actually needed if we simply look outside eye care ... at the hospitals. If we follow hospital news, we'll see the road ahead for eye care, really for the domains of care of all independent practitioners.


Today's look at Becker's Hospital Review reveals yet another new healthcare model: the integrated care model, or network. Two have been announced in the last week, one in Central Georgia and the other in Western New York. Let's look at the one in New York since it involves a BCBS partnership. The bolded words are mine, for emphasis.

"BlueCross BlueShield of Western New York and Kaleida Health of Buffalo, N.Y., announced plans to partner and form an integrated care model, the first of its kind in the Buffalo region.

The model includes a network of Western New York physicians partnering with health system Kaleida and health insurer BCBS to create a physician-led organization. It's a first of its kind healthcare delivery model for the Buffalo region in that it combines a health plan, health system and group of physicians providing patient-centered care.

It's essentially a commercial accountable care organization. Kaleida Health refers to it as a "strategic partnership" intended to "assure accountability for both the clinical outcomes of the patients and the costs of the care delivery model."

Are we drifting off into aspects of health care reform that don't apply to ECPs? Absolutely not. Admittedly, we still feel the need to point to the evidence that says (a) health care is transforming, and (b) the very changes we're seeing today in the hospitals are the changes we'll see in your practice tomorrow. If we're harping on HIEs and ACOs, it's because these entities matter for you. This is not about stimulus money, neither grants nor penalties. It's about the survival of your business.


Action items for ECPs:

1. Find out about your state HIE and how you can get connected to it.
2. Inquire about local ACOs and what it takes to belong to a care team.
3. Ask your software vendor about their readiness to offer you ONC Direct. (We have written a number of posts recently on HISPs and ONC Direct. See those for more details.)
4. At the bottom of this post, see "Comments and Reactions". If you have a question, click on that title and type away. We'll be more than happy to respond.

Alistair Jackson, M.Ed.