Kate Ryan<br />National Women‘s Health Network<br />August 12, 2011<br />Promoting Evidence-based Health Care in ACOs<br />
Goals of the ACO model<br />ACOs will have dual measures of success<br />improving the quality of care <br />lowering the ...
Evidence in ACOs<br />The ACA requires an ACO to "define processes to promote evidence-based medicine”  and the HHS regula...
ACO definition of EBHC<br />In the regulation, evidence-based health care: <br />seeks to assess the strength of evidence ...
General Plan to Promote EBHC<br />To demonstrate incorporation of EBHC, ACOs should:<br />Describe the evidence-based guid...
ACOs & Chronic Conditions<br />ACO population is more likely to have chronic conditions, and women are disproportionately ...
Chronic Conditions & Evidence<br />Older adults with multiple chronic health conditions report<br />duplicate tests and pr...
Evidence in Practice<br />Evidence-based practices to lower readmission rates<br />greater attention to follow-up care dur...
Women’s Health in ACOs<br />Because women live longer, older women are more likely than men to have multiple chronic condi...
Communication & Patient Engagement<br />Reduce unnecessary treatment by improving communication<br />Improve patient under...
Communication & Patient Engagement<br />Ensure patients understand their treatment options<br />Communicate the evidence o...
The Impact of EBHC<br />Improved communication and patient engagement can reduce unnecessary hospitalizations, tests and t...
Conclusion<br />Widespread use of evidence-based health care in ACOs can:<br />Improve communication with patients<br />En...
Questions?<br />How could ACO's be a useful tool for promoting evidence-based care?<br />What are the current evidence-bas...
Questions?<br />How should we recommend that ACOs measure their success in promoting evidence-based health care?<br />Quan...
Thank you<br />Kate Ryan<br />National Women’s Health Network<br />202-682-2640<br />kryan@nwhn.org<br />
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**Ryan - Promoting Evidence-based Healthcare in Accountable Care Organizations

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Kate Ryan, National Women's Health Network.
This is Part 2. For the beginning of the Workshop, please see Sloan - Workshop C - Part 1.

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**Ryan - Promoting Evidence-based Healthcare in Accountable Care Organizations

  1. 1. Kate Ryan<br />National Women‘s Health Network<br />August 12, 2011<br />Promoting Evidence-based Health Care in ACOs<br />
  2. 2. Goals of the ACO model<br />ACOs will have dual measures of success<br />improving the quality of care <br />lowering the cost of care<br />How can these goals be achieved through increased use of evidence-based health care (EBHC)?<br />
  3. 3. Evidence in ACOs<br />The ACA requires an ACO to "define processes to promote evidence-based medicine” and the HHS regulation allows for flexibility within the ACO model<br />Each proposed ACO must provide documentation in its application describing its plans to promote evidence-based medicine<br />
  4. 4. ACO definition of EBHC<br />In the regulation, evidence-based health care: <br />seeks to assess the strength of evidence of the risks and benefits of treatments (including lack of treatment) and diagnostic tests based on the best available scientific evidence<br />applies this evidence to the processes of medical decision-making and treatment<br />
  5. 5. General Plan to Promote EBHC<br />To demonstrate incorporation of EBHC, ACOs should:<br />Describe the evidence-based guidelines it will follow or establish<br />Describe how it will implement these guidelines<br />Describe how it will demonstrate it is following these guidelines<br />
  6. 6. ACOs & Chronic Conditions<br />ACO population is more likely to have chronic conditions, and women are disproportionately impacted<br />90% of older adults have at least one chronic health condition<br />77% have multiple chronic conditions.<br />96% of Medicare dollars is spent on patients with multiple chronic conditions.<br />
  7. 7. Chronic Conditions & Evidence<br />Older adults with multiple chronic health conditions report<br />duplicate tests and procedures<br />conflicting diagnoses for the same set of symptoms<br />contradictory medical information<br />not receiving adequate information about potential drug interactions when they fill prescriptions.<br />How could evidence-based guidelines address these problems?<br />
  8. 8. Evidence in Practice<br />Evidence-based practices to lower readmission rates<br />greater attention to follow-up care during hospital discharge results in lower readmission rates 1<br />female stroke survivors are less likely than males to receive complete stoke prevention information including medication and outpatient follow-up 2<br />Helfand, Duke. “Health care partnership pays big dividends.” Los Angeles Times. August 1, 2011. http://articles.latimes.com/2011/aug/01/business/la-fi-healthcare-savings-20110802<br />Agency for Healthcare Research and Quality (AHRQ), Health Care for Minority Women: Recent Findings (Pub. No. 11P005). Rockville MD: AHRQ, 2010. Available online at: http://www.ahrq.gov/research/minority.htm<br />
  9. 9. Women’s Health in ACOs<br />Because women live longer, older women are more likely than men to have multiple chronic conditions that require care coordination<br />Socio-economically disadvantaged and minority women experience the highest burden of chronic illness, disability, and co-morbidity 1<br />Bierman AS and CM Clancy, “Health disparities among older women: identifying opportunities to improve quality of care and functional health outcomes”, Journal of the American Medical Women’s Association 2001; 56(4): 155-159, 188.<br />
  10. 10. Communication & Patient Engagement<br />Reduce unnecessary treatment by improving communication<br />Improve patient understanding of follow up care<br />Reduce the potential for dangerous drug interactions<br /> Reduce hospital readmission rates<br />
  11. 11. Communication & Patient Engagement<br />Ensure patients understand their treatment options<br />Communicate the evidence of risks and benefits for all available treatments<br />Hot flashes<br />Osteoporosis<br />Talk to patients about their values and priorities<br />
  12. 12. The Impact of EBHC<br />Improved communication and patient engagement can reduce unnecessary hospitalizations, tests and treatments and indirectly lower costs<br />Health care providers could also lower costs by promoting use of generic drugs when they are available<br />
  13. 13. Conclusion<br />Widespread use of evidence-based health care in ACOs can:<br />Improve communication with patients<br />Engage patients in decisions making<br />Reduce unnecessary hospitalizations, tests and treatments<br />Reduce costs to the health care system<br />
  14. 14. Questions?<br />How could ACO's be a useful tool for promoting evidence-based care?<br />What are the current evidence-based practices for coordinating care that ACOs could model?<br />
  15. 15. Questions?<br />How should we recommend that ACOs measure their success in promoting evidence-based health care?<br />Quantitative/qualitative metrics?<br />
  16. 16. Thank you<br />Kate Ryan<br />National Women’s Health Network<br />202-682-2640<br />kryan@nwhn.org<br />

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