Dedicating time and leadership to understanding the communities our ACOs serve is integral to successful population health management programs. Caravan Health’s General Manager of ACO Programs drives that initiative by working with executive leaders who represent their communities on ACO boards. In this way, we ensure Caravan Health is continually improving the services we offer to bring real value to our
General Manager of ACO Programs, Greg Paris
, served as CEO at Monroe County Hospital for almost 20 years, and then spent another seven with StuderGroup, the largest health care consulting company in the U.S. He now works closely with executives who represent communities on ACO boards to drive successful programs while keeping the needs of their respective populations at the forefront. We asked Mr. Paris to offer some advice to ACOs about the challenges health systems and organizations face and what they can do to thrive in value-based care.
What are some ways Caravan Health services have evolved over the years to ensure clients are successful in the ACO program?
When we started out, we very much had a consistent set of tactics that we wanted to execute, and we hardwired those tactics into our programs because we knew for certain that they work. But we’ve also learned that we need to individualize our game plan with each client. Everybody's got some unique opportunities and unique needs, and we know how to identify those and build around them to best position their ACOs for success.
Another way our services have evolved is to focus on expanding our relationship-building capabilities across the board, especially with our clients’ executives. We also make sure we are spending dedicated time with our clients, in between our board meetings, with the sole focus of building relationships. This allows us to get to know each other and make sure we're proactively following up on any issues or questions they might have that they don’t or won’t ask at those board meetings.
These things, combined with a deep understanding of the market, are so critical to allow us to be trusted advisors to our clients. This is new and complicated stuff, it’s constantly evolving, and our clients don't have the time or resources to keep pace with the changes and strategies around population health and value-based care. And, really, they shouldn’t have to. It’s our job to help them be free to do their jobs and focus on patients and care. We pride ourselves on being able to help them identify and execute on those strategies that will most benefit them and their patients.
What do successful ACO organizations do differently than those that aren’t successful?
It takes a little bit of time, but you can see some of the results in a data packet and look at some of the tactics they are deploying. There's a direct correlation between whether they do the tactics and whether they get the results.
So, for example, we know that annual wellness visits are the number one way to improve the preventive care received by your patients and to drive your quality results. If we looked at an ACO with, say, twelve different client organizations in the ACO, you might not see a single one of them that really stood out, but you would see that not a single one was below average in quality scores. And if you looked at why, you would see that everybody was doing the work. And if you dug deeper, you would look at those basic tactics of annual wellness visits and chronic care management and see that they were all doing them.
“There's a direct correlation between whether they do the tactics and whether they get the results."
What are some of the challenges health systems face as they transition into ACOs?
We’ve learned to identify some “red flags” for health systems and physicians. One would be any time there is executive turnover and insufficient onboarding for new leadership to bring them up to speed on ACOs and the program tactics and needs. Another would be getting medical staff engaged with the connection back to the “why are we doing this.” And a third one would just be the dedication and commitment – or lack of the dedication and commitment – to doing things differently.
Really, you have to sometimes look past just revenue for a while to understand that this is really the way that we were designed to deliver health care in the beginning. Isn't it right that we're talking about vaccines that prevent you from getting sick rather than always just treating you when you get sick? And you have to keep that patient in mind, and that's on us to highlight stories and talk about results and always put a patient face on them. Doing a good job with that helps health systems avoid challenges or getting so focused on the money that they forget there's a bigger reason why we're doing this.
What is holding health systems back from achieving success in value-based care?
It's a really fragmented world out there in the health care industry, and beyond. There is nothing that says you have to go do this work in ACOs. CMS has used a variety of “carrots” and “sticks” to try to move people there, but not everybody has
to go, and so it's complicated. When you throw all those factors together, sometimes folks will just sort of put their head in the sand. And it turns into, “I'm not going to change until I either understand why the place you're telling me I have to go to is better for me or until somebody forces me to go there.” That attitude and fear, and sometimes the inability to just find or make the time to learn about things, holds systems back.
We can help with that, but the boldest folks are the ones who take advantage of all we have to offer and make the decision to move
. And that's a really tough thing to do. Partly because it's new. Partly because it's complicated.
Ultimately, we have to remember that health care, regardless of what you do in the industry, is a relationship business. When you realize that, you hold each other accountable in all your partnerships – whether that’s with patients, doctors, executives, or ACO partners – and that accountability will ultimately serve the greater good as value-based care was intended to do.
Caravan Health helps physicians and hospitals work together to create, operate and manage successful population health programs that improve patient care, clinician satisfaction and financial performance.
Watch our explainer video to learn more.