Dog Sledding and ACOs: What Do Health IT Leaders Do When the Lead Dogs Fail?

Ken Perez

Guest post by Ken Perez, Director of Healthcare Policy and Senior Vice President of Marketing, MedeAnalytics, Inc.

Recently, Mitch Seavey, 53, became the oldest winner of the Iditarod, the most famous dog sledding race in the world. At a distance of 1,600 kilometers, the Iditarod constitutes a race of supreme endurance. In dog sledding, the dogs that are chosen to lead the sled are usually the smartest, as well as the fastest, and they are appropriately called lead dogs.

The lead dogs in the realm of Medicare ACOs are the 32 pioneer ACOs, the selection of which was announced in December 2011 with great fanfare and optimism. With the greater risks (and rewards) of the pioneer ACO Model, the pioneers were widely considered the best and the brightest, the organizations most likely to succeed as ACOs.

However, on Feb. 25, 2013, 30 of the pioneers sent a letter to the Center for Medicare and Medicaid Innovation (CMMI), requesting that the requirement for Medicare bonuses for 2013 be relaxed to simply reporting, not performance against benchmarks. The letter was first reported by Inside Health Policy, and a few other publications, including The Washington Post, covered this development, but to date, no one has characterized the significance of this signaling by the vast majority of the pioneers that their overall performance versus the quality benchmarks will probably be subpar for 2013. According to CMS, their first-year performance results will be made public in June. That is when the rubber will meet the road.

If the pioneers, the lead dogs of the Medicare ACOs, apparently are missing the mark for 2013, what are the implications for the other types of Medicare ACOs, which generally have been viewed as less likely to succeed?

Clearly, given the numerous quality benchmarks and cost-savings targets, one cannot emphasize enough the importance of data analytics to manage performance and give any ACO — Medicare or commercial — a fighting chance to succeed in the race to accountable care.

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