Looking Ahead

Thoughts from Our Board Chair

In past years, the ACO and its participants have made progress in improving clinical documentation and performance on a number of quality measures. This progress is due in great part to care teams’ concerted efforts to influence performance in these areas – efforts that are now well established and supported across the ACO.

Confident in the ongoing stability and success of the clinical documentation and quality improvement work, the ACO is now turning its attention to a third area of concern with implications for both patient outcomes and total cost of care: unwarranted variation in clinical practice. Such variation can be reduced through standardized clinical criteria and clear decision processes, among other interventions.¹

The ACO’s Value Oversight Committee has recommended focusing variation reduction efforts on end-of-life care and transitions of care, two areas with significant impact on total cost of care and clinical outcomes. Additional areas of focus will be identified in the future.

Reducing Unwanted Care Variation

Chief Operating Officer Shannon Banks discusses MHACO-endorsed initiative to reduce unwarranted care variation.

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Supporting Patients

Our focus on transitions of care will be supporting patients in that critical, and high-risk, time between a hospital or rehab discharge and getting in to see their PCP or specialist for a follow-up visit.

Our focus on end-of-life care will be to increase the number of patients dying from cancer who receive at least 10 days of hospice care – an accepted metric of high quality end-of-life care. Because many patients wish to have care focused on their comfort at end-of-life, involvement of specialty palliative care early in the disease course will also be a focus. Palliative care has been shown to increase duration of hospice care, notably without changing how long a patient lives.

Supporting ACO Participants

The ACO’s governing board, leaders and team members are excited to partner with participants to make real improvements in care variation reduction. The ACO has developed powerful resources to help ensure progress in these areas, including the newly-released Value Report analytics tool and the solution-oriented conversations it makes possible.

There is no doubt we’ve entered a time of sudden and radical change in health care. With the close collaboration of the ACO and participating practices, that change can be transformed into an opportunity – an opportunity to improve patient outcomes and lower total cost of care. I look forward to what we can achieve together in the consequential years to come.

Carl DeMars, MDCarl DeMars, MD
VP. Physician and APP Services, Coastal Region, MaineHealth
MHACO Board Chair

¹Atsma F, Elwyn G, Westert G. Understanding unwarranted variation in clinical practice: a focus on network effects, reflective medicine and learning health systems. Int J Qual Health Care. 2020 Jun 4;32(4):271-274. doi: 10.1093/intqhc/mzaa023. PMID: 32319525; PMCID: PMC7270826.