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Physician ACOs 2014

Physician ACOs 2014
Variations on the Accountable Care Theme

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Physician organizations are taking up the accountable care banner and now lead more ACOs than do hospitals and IDNs. Recent results from the first wave of Medicare ACOs show that a majority of those earning bonuses are physician led. For some, this is a surprise considering that physician groups often lack capital and established care networks. To better understand the approach of physician-led ACOs and the vendors supporting them, KLAS interviewed 46 organizations.

KLAS Report: Physician ACO

WORTH KNOWING

ECLINICALWORKS AND EPIC STAND OUT AMONG EMR VENDORS.

Overall, EMR vendors are not ready for ACO prime time, rating on average 6.3 on a 9.0 scale for meeting ACO needs. The closest to being exceptions are eClinicalWorks and Epic, who rate 7.0 and 7.3, respectively. eClinicalWorks is the most used across all functional categories, while Epic offers completeness of data in more centralized ACOs. 

THE BIGGEST OPPORTUNITY FOR THIRD-PARTY VENDORS: RISK STRATIFICATION.

Overall, third-party vendors rate higher than EMR vendors in all functional categories, but they do so most notably in risk stratification. 68% of respondents use a third-party vendor, compared with 15% who rely on an EMR vendor. Advisory Board, MEDecision, Optum, and Phytel are the vendors most often deployed.

FEW STANDOUTS IN A CROWD OF THIRD-PARTY VENDORS

Among a diverse crowd of 25 vendors, only 1—Optum—stands out in terms of adoption. They are used by four organizations. Only 7 other vendors were mentioned more than once, and none of those were mentioned more than twice. Unlike EMR vendors, third-party vendors show little affinity for ACO type. Most population health vendors are used across hospital partners, medical groups, and independent associations.

ASSOCIATIONS MOST CHALLENGED; MEDICAL GROUPS TAKE THE MOST RISK

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Without strong governance and a standard EMR, most independent associations rely on third-party tools and claims data. As a result, associations are least likely to take on higher-risk contracts, and most stick with low-risk MSSPs. In contrast, medical groups with centralized management, standardized EMRs, and higher rates of employed physicians (as opposed to independent physicians) take on greater risks associated with Medicare Advantage and commercial health plans.

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This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2018 KLAS Enterprises, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.