Clinical Integration and Accountable Care Organization Development

Clinical integration ("CI") and accountable care organizations ("ACOs") are really two sides of the same coin. These new words define how healthcare organizations think and act to become more effective and efficient in meeting their mission and vision for health and healthcare. CI is the process—or the "way"—and an ACO is the structure. At The Camden Group, we can help you define the "why, how, and what" that is needed to become clinically integrated, as well as the structure (i.e., ACO) to support the integration.

We understand that to be an ACO, a relentless focus on CI and redesigning clinical care delivery is necessary to find new ways of improving efficiency, service, and quality—AND it must be must done continuously. Additionally, the business framework and financial relationships must support these goals. A framework of governance, management, clinical care support, IT, data analysis, incentive structures, payer relationships are required to meet market demands for service, quality, and efficiency. Ultimately, the organization must create value and be able to prove it. It is a journey with milestones—not a destination; a journey to be taken with a partner, and not a solo-effort. Our thought leaders have trail blazed a path for this new era of healthcare delivery, and we are ready to guide and collaborate with you to help you achieve clinical integration and become an ACO.

Unparalleled Knowledge, Firsthand Experience, and Exclusive Access

Our multidisciplinary team is uniquely qualified to assist you in achieving clinical integration and becoming an ACO. Composed of the nation's leading experts in this area, our healthcare executives, physician leaders, and advisors have firsthand experience and success.

Providing Board and Executive Management Education and Advice

What does the discussion about healthcare reform mean for you? What can you expect in the form of payment reform with or without legislation? Accountable care organizations and clinical integration—what are they? Why should you consider becoming one? What does it mean to be one? What are the benefits? Who is doing it? How have they been successful? Why now?

Our full service organization has been helping executives and boards of hospitals, health systems, physician groups, and physician-hospital organizations understand these types of challenges for years. We have created a highly intense and interactive program provided by team members who are successful executives, physician leaders, and advisors. Our education program's objective is to challenge, enlighten, develop interest, and prompt questions while ensuring your leaders understand CI and ACOs, their benefits to your organization, their pitfalls, and the ways others have succeeded.

Helping You Achieve Clinical Integration

With the use of our proprietary CI tools, we facilitate a process that results in the articulation of the vision and scope of clinical data sharing, disease management, outcomes reporting, financial impact, and payer relationships. We also provide an objective review of what it will take to achieve a vision of clinical integration:

• The market and the product(s) to be offered
• The network's capabilities and organizational readiness
• Engaging physicians: collecting data and measuring, monitoring, and rewarding performance
• Clinical data sharing and reporting; portal use for real-time reporting and alerts
• Supporting effective care processes across the care continuum (e.g., inpatient, outpatient, post-acute, home care, and wellness and disease prevention)
• Market dynamics and payer relationships: opportunities and obstacles
• Achieving FTC definitions of clinical integration

The result is a clearly articulated plan, with practical application of what is achievable, the structures and capabilities that will be required, and the strategies to achieve the short-term and long-term goals for clinical integration, clinical performance optimization, and creation of a sustainable integrated delivery system.

Determining Your ACO Readiness and Gap Analysis

Is your organization ready to become an ACO? Based on our unique experience and strategic alliances, we have identified and developed both processes and proprietary tools to help our clients achieve clinical integration and become an ACO. Using Camden's ACO Readiness Assessment TestSM and Camden's ACO Check ListSM, we provide a physician group, hospital, and health system an overview of the organization's readiness to become an ACO. Our multi-disciplinary team will assess your organization's capabilities, interview key stakeholders, establish readiness, and identify your profile of current readiness. You will understand your strengths and weaknesses in order to best address challenges that you will likely face on your way to becoming a clinically integrated accountable care organization. This will form the basis for the development of a business plan and roadmap for ACO development.

Helping You Become an Accountable Care Organization: The Implementation

So you want to become an ACO. You have completed the assessment and understand what needs and challenges must be addressed to develop and implement a plan. You understand you need to support your team as it progresses toward clinical integration and ultimately becoming an accountable care organization, and so do we. Our clients value our "clients-first" approach - one that blends both collaboration and customized detailed analyses in order to develop implementation programs that are client and market specific. We provide strategy and business advice, project management, reviews and progress reporting to leadership, and focus as your organization works through the changes that must occur to be a success in clinical integration and as an accountable care organization. We have answered the questions you will face, including those illustrated below, as well as many others.

• Governance structure and management process
• Payer relationships and contracting
• Business management reporting: efficiency and referral patterns
  • Provider contracting and incentive structures
• Clinical delivery network design
  • Requirements for participation
  • Scope of services
• Clinical integration adoption strategy
  • Clinical guideline structure and development
  • Clinical guideline delivery
  • Real time, point-of-care alerts, care opportunity reports
  • Clinical measure development
  • Physician performance reports
  • Physician and network monitoring reports
• Information systems selection and development with data source management
  • Physician and patient portals; secure transparency management
  • Physician IT services and MSO program development
  • Implementation management

To learn more about how we can assist your organization in achieving clinical integration and/or becoming an accountable care organization, please contact us today.