Zynx Health, the market leader in providing evidence-based and experience-based clinical decision support solutions, today announced its response to the proposed regulations governing Accountable Care Organizations (ACOs) issued by the Centers for Medicare & Medicaid Services (CMS).
WHAT: On March 31, 2011, the Department of Health and Human Services issued proposed regulations governing ACOs under the Medicare Shared Savings Program established by the Patient Protection and Affordable Care Act of 2010.
The proposed regulations highlight the role that evidence-based clinical decision support plays in successful creation and sustainment of ACOs. According to the CMS document:
- "The ACO would develop and implement evidence-based medical practice or clinical guidelines and processes for delivering care consistent with the goals of better care for individuals, better health for populations, lower growth in expenditures. The guidelines and care delivery processes would cover diagnoses with significant potential for the ACO to achieve quality and cost improvements, taking into account the circumstances of the individual beneficiary, and could be accomplished, for example, through an integrated electronic health record with clinical decision support. ACO participants and ACO providers/suppliers would have to agree to comply with these guidelines and processes and to be subject to performance evaluations and potential remedial actions."
- "The ACO would have an infrastructure, such as information technology, that enables the ACO to collect and evaluate data and provide feedback to the ACO providers/suppliers across the entire organization, including providing information to influence care at the point of care via, for example, shared clinical decision support, feedback from patient experience of care surveys or other internal or external quality and utilization assessments."
- "[An approach to evidence-based medicine] should involve the establishment and implementation of evidence-based guidelines, based on the best available evidence concerning the effectiveness of medical treatments, at the organizational or institutional level. A genuine evidence-based approach would also involve regularly assessing and updating such guidelines to promote continuous improvement in the quality of care in light of new evidence concerning the effectiveness of medical treatments."
WHO: The following is a comment from Scott Weingarten, MD, MPH, president and CEO of Zynx Health, the market leader in providing evidence-based and experience-based clinical decision support solutions:
"The proposed rules provide guidance on how healthcare organizations can participate in ACOs to improve quality and cost outcomes of care. The rules also encourage a closer alignment between healthcare providers and suppliers through increased collaboration and evidence-based clinical decision support. Clinical decision support provides the foundation for improving cost and quality outcomes across the continuum of patient care."
In October 2010, Zynx Health launched an ACO pilot program, partnering with five healthcare organizations to analyze their clinical decision support and provide specific recommendations related to key clinical processes that directly impact cost and quality outcomes. Based on the success of the ACO pilot program, Zynx Health has expanded the effort to include additional healthcare organizations.