The Central Role of Physician Leadership for Driving Change in Value-Based Care Environments

This case study analyzing accountable care organizations looks at lessons learned from the implementation of the American Medical Group Foundation’s Measure Up/Pressure Down initiative.

Authors: Lustig A; Ogden M; Brenner RW; Penso J; Westrich KD; Dubois RW.
Publication: Journal of Managed Care & Specialty Pharmacy, October 2016, pp. 1116-1122.
 

In a case study analyzing accountable care organizations (ACOs), the National Pharmaceutical Council (NPC), Cornerstone Health Care, Summit Medical Group and the American Medical Group Association look at lessons learned from the implementation of the American Medical Group Foundation’s Measure Up/Pressure Down initiative. It echoes the same themes NPC has uncovered in other studies of ACO programs, including:

  1. The need to have a champion in the company to promote the ideas;
  2. The need for strong communication among those engaged in the processes; and
  3. The ability to track or show return on investment or relevance.

In the case of the Measure Up/Pressure Down campaign as implemented by Cornerstone Health Care (CHC) and Summit Medical Group (SMG), doctors and nurses identified patients with hypertension and worked with them to get their condition under control, aiming to reach a goal of 80% hypertension control. Researchers found that the strategies employed by both SMG and CHC, such as leveraging data analysis to identify at-risk patients and comparing physician performance, as well as identifying leaders to institute change, can be replicated by an ACO or a managed care organization (MCO). An MCO can provide data analysis services, sparing the provider groups the analytic burden and helping the MCO build a more meaningful relationship with their providers.