For the National Association of ACOs (NAACOS) Spring Conference, I had the pleasure of interviewing Imperium Health CEO, Gary Albers. Imperium chose Lightbeam in 2019 as the technology partner to assist with their Accountable Care Organizations (ACOs), commercial and Medicare Advantage plans, employers, health systems, and physician clients. Imperium clients achieved over $94 million in Medicare savings for the 2019 performance year to testify to the partnership’s success.
Today on Lightbeam’s blog, I thought I would recap some of the key points we discussed for those that are not NAACOS members. I also encourage you to watch the video below to hear the entire discussion.
An Overview of the Future of Risk
Gary and I discussed where we stand in 2021, some critical thoughts regarding ACO and shared savings efforts, how we feel about the continued push to risk, and wisdom for the future. To set the context for our discussion, it has become clear that the Centers for Medicare & Medicaid Services (CMS) is moving away from upside-only risk to actual shared risk and full-risk models.
Gary believes the best thing CMS could do is refine and reintroduce the Advance Payment initiatives and Next Generation model. As it stands currently, CMS has decided to sunset the Next Gen model after this year, shifting the focus to the Direct Contracting model. NAACOS continues to lobby on these issues with the best long-term interest of their ACO members and patients.
Embracing Industry-Wide Changes and Point-of-Care Tools
There have been some significant shifts in the industry regarding policy due to the 21st Century Cures Act. The policy represents a meaningful change in the requirements around clinical integration. Gary and I are passionate about the Cures Act and its endorsement of the FHIR standard; with it, we will see clinical data sharing becoming much more consistent, portable, and efficient.
Leveraging these new standards, it is critical to focus on informed decision-making and use point-of-care tools to make the most of every patient encounter. Adding capabilities like the Lightbeam Ribbon Solution, a powerful pop-up tool that automatically displays patients’ care gaps when logging into the native EMR workflow, is one way physicians can efficiently address critical needs.
Lastly, the CMS 21st Century Cures rule injects new energy into an old data transaction. HL7 ADT notifications have been a part of the interoperable landscape for years. Still, they have never realized their full value due to a lack of buy-in from the hospital community. The new CMS Condition of Participation requires delivering these ADT transactions to the patient’s care team to ensure timely notification of notable events. Lightbeam’s mobile-friendly ADT Insights delivers near real-time communication of these and other significant care developments via text, configurable by provider preference.
Advice to Healthcare Organization Leaders
In conclusion, Gary shared some reflections based on his years in healthcare that I thought would be valuable to share.
- As an industry, we have generated immense value-based care success. Besides the dedication of each organization, much of that can be attributed to our investments in technology.
- Recognize your success and learn from your failings.
- Be patient, remain focused, encourage your team, and you are bound for success.
I hope you will watch the entire dialogue between Gary and me below!
Kent Locklear, MD, MBA, is Lightbeam’s Chief Medical Officer.