In planning for the long-term, AMCs should partner with (but not necessarily acquire) primary care providers and begin piloting care delivery models, payment models (eg, bundled payment) and care coordination strategies. Taking a data-driven approach to pilots is a helpful way to incrementally redesign care. Ultimately, metrics will make AMC partnerships more accountable for the care of patients in the community. AMCs should focus on areas such as hip replacements, cardiac surgery and high-risk obstetrics, in which the AMC has the means and opportunity to decrease utilization of expensive services. Regardless of the partnerships that emerge, a strong System of CARE (Clinical Alignment and Resource Effectiveness) provides the best foundation for any 3-letter acronym of the future.
Sources: Berkowitz SA and Miller ED. Accountable care at academic medical centers—lessons from Johns Hopkins. N Engl J Med 2011;364:e12(1)–e12(3) [Epublication ahead of print]; Kastor JA. Accountable care organizations at academic medical centers. N Engl J Med 2011;364:e11(1)–e11(3) [Epublication ahead of print]; Sg2 Interview With Montefiore Care Management Organization, February 2011; Chase D. Montefiore Medical Center Case Study. The Commonwealth Fund: October 2010; HR 3664: Healthcare Innovation Zone Pilot Act of 2009.
Julie Schulz, MD, is a consultant for Sg2