You know that whole thing about accountable care organizations being like unicorns, well Optum has formed what may be the nation's first major posse to try and hunt down the mythical creature. Optum, a technology and services offshoot of mega-insurer UnitedHealth Group, yesterday officially launched the Optum Institute for Sustainable Health.
The institute has a twofold mission: to gather and assess data on the "rapidly changing health care landscape," as well as to work with providers, employers, government and community leaders to create what it calls "sustainable health communities — clinically integrated, financially viable health systems that increase the quality of care, improve patient experience and lower overall health care costs." It may just be semantics, but that sounds a lot like the expressed goal of the multitude of accountable care projects being launched across the country.
Carol Simon, director of the Optum Institute, says the group will be able to tap in vast amounts of data to analyze what's working, what isn't working and why. "We can drill down on what moved [an organization] from point A to point B," she told me during an interview yesterday morning. They'll look specifically at what happened, for instance, when a hospital engaged the physician community in a discussion about clinical integration. Then, the goal will be to figure out if and how successful concepts can be exported to the larger community.
"Everyone can point to Grand Junction, Colo., or Marshfield, Wis., and say these models work well," she says. But the question is what resources were brought to bear in those communities to forge such success stories, or are they really just unique situations? Those are the questions the institute hopes to answer.
Simon says the institute may partner with UnitedHealth, but will remain independent of the insurer, adding that the institute will seek partnerships far and wide across the health care spectrum. A key element, she says, will be adding the community to the equation, which is partly why they selected the phrase "sustainable health communities."
Community seems to be applied both broadly and narrowly here. The Optum Institute believes that all stakeholders — hospitals, doctors, post-acute facilities, employers and payers — need to be part of the conversation. And, importantly, so do patients.
"There is a strong belief that consumers need to be engaged," she says, suggesting that in the current conversation around ACOs, the consumer has more of a passive role. She references such things as using technology to give patients greater access to their medical records and having a more collaborative approach to discharge planning.
As a first step in its efforts to analyze the health care landscape, the institute, along with Harris Interactive, in October conducted a poll of 1,000 primary care docs and specialists, 400 hospital executives and 2,000 patients. It released some of findings yesterday, some of which are pretty telling:
- 64 percent of physicians say there are "significant differences in the quality of care provided by doctors" in their local area.
- Consumers believe that needed preventive health care is only delivered 33 percent of the time; physicians believe it is 50 percent of the time.
- 90 percent of docs say believe they'll be using an EMR within 2-3 years, but only 47 percent of those systems allow doctors to share data with hospitals.
- 35 percent of doctors and 40 percent of hospital execs believe that upwards of a quarter of revenues will be tied to performance. The survey also showed that a significant proportion of providers do not feel prepared to take on the financial risk, Simon says.
The institute has several more surveys and studies planned for later this year and in 2012, including a look at the current ACO market.
Matthew Weinstock is senior editor at H&HN. You can reach him at firstname.lastname@example.org.