December 02, 2011

Accountable care organizations, prescribed by the healthcare reform bill, have been in and out of the news all year. Obviously there's a role for insurers to play in these entities, but there has been a question: How much of it is about technology, and how much is just about process?

Well, the selling point for insurers in terms of setting up ACOs — whose major goal is to "make providers jointly accountable for the health of their patients, giving them strong incentives to cooperate and save money by avoiding unnecessary tests and procedures" — is that they have the cross-provider data required to enable a full view of the patient.

It's something Arkansas Blue Cross and Blue Shield CIO Joseph Smith told me when we spoke for his Elite 8 profile. "The emerging accountable care organizations and patient-centered medical homes are going to have a thirst for information, and we're going to be well-positioned to provide a lot of the analytics based on what we know about the member," Smith said.

InformationWeek had a story this week about how Aetna is developing a health plan specifically to work with ACOs in concert with the Banner physician network. The plan includes heavy use of electronic health records and analytics on the insurer side, and next-generation monitoring and alert capabilities on the provider side. This shows that ACOs will require technological collaboration between insurer and provider to be truly successful in reducing healthcare costs and increasing effectiveness.

ABOUT THE AUTHOR
Nathan Golia is senior editor of Insurance & Technology. He joined the publication in 2010 as associate editor and covers all aspects of the nexus between insurance and information technology, including mobility, ...