Ahead of the marcus evans ACO & Payer Leadership Summit 2024, Ruth Krystopolski discusses the technology needed to empower value-based care in a community.

1. Interview with: Ruth Krystopolski,
President, Ayin Health Solutions
“The patient population and payer mix
of every ACO varies by community and
region. To provide truly coordinated
value-based care in a meaningful way,
the technology used to support ACOs
must be flexible, customizable and able
to evolve as the ACO’s needs mature
and change,” says Ruth Krystopolski,
President, Ayin Health Solutions.
Ayin Health Solutions is a platform
technology and administrative service
provider at the marcus evans ACO &
Payer Leadership Summit 2024.
What are the main challenges that
ACOs are facing today?
Typically, ACO challenges fall into three
major categories. First is understanding
who is included in the population being
served. Many leaders do not have
visibility into which programs and
contracts their patients are part of.
Second is having access to all necessary
data to understand the underlying
needs and behaviors of the population,
and the outcomes you have achieved.
Third, the ability to define and compen-
sate their network of providers in ways
to successfully drive toward value.
Organizations would benefit from a
flexible, highly tailored cloud-based
solution that can evolve as they pro-
gress on their value journey. As each
ACO is working in a different environ-
ment, serving different populations with
different provider arrangements,
utilizing a technology and service
provider that can support them in their
current environment while evolving as
their needs change supports ultimate
success. Having the ability to utilize a
fully supported platform allows organi-
zations to focus on improving care and
value for the patients they serve
without having to staff an entire IT
department, address new and changing
measures, install upgrades or enhance-
ments or evaluate ongoing technology
changes. Additionally, data integration
can be tricky and expensive, particularly
if the ACO is working in a multi-provider
system.
What would make the health care
experience more efficient? What
kind of technology would empower
value-based care?
One of the biggest challenges in
healthcare today is the need to inte-
grate data across multiple platform
systems, EHRs and administrative data
sets, and then utilize that data to help
drive workflows, processes, and provide
actionable interventions that drive
value. Our goal is to bring the various
data sources together in a single
platform and make it accessible to the
providers across a community caring for
a patient while also driving improved
performance across meaningful metrics
for the ACO. Many of the current
technology solutions do not have the
ability to provide visibility around a
single patient to multiple providers in
the community.
What healthcare trends or future
should ACOs prepare for? What do
they need to know?
First of all, we will continue to see
models evolve over time. Who we
include in the populations served and
how they are paid for will continue to
change. The ability to navigate that
evolution will be very important, and
having a partner who can evolve with
the ACO will be vital to success. We will
also need to focus on broader popula-
tions than we have in the past. Many
ACOs have been primarily focused on
the Medicare and the 65 plus popula-
tion, whether it was through CMS
programs for Medicare patients or a
Medicare Advantage product. Evolution
of models in Medicaid and commercial
populations will continue to advance,
and the information to address needs in
these populations is very different than
our Medicare aged cohorts. ACOs will
need the ability to address needs across
different population groups.
The capacity to pay in new and different
ways, and incentivizing our provider
community outside of the fees-for-
service environment will also be very
important over time. ACO partners will
need the capacity to support capitation
and sub capitation arrangements,
bundles, episodes and a variety of other
payment arrangements.
Data
integration
can be
tricky and
expensive,
particularly
if the ACO is
working in a
multi-provider
system
Empowering Value-Based Care

2. About Ayin Health Solutions
Ayin Health Solutions, a wholly owned subsidiary of Providence Health, is a population health platform technology and
administrative service provider focused on delivering solutions that support risk bearing entities such as health plans, CCOs, ACOs,
CINs, Employers and Provider Groups on their value-based care journey. Ayin is committed to the mission of making the complex
simple… supporting healthcare in reducing cost, improving care, and addressing the shifting healthcare landscape.
www.ayin.com
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