Failure of Health IT Systems Hinders ACO Cost Savings

The inability of health IT systems to communicate with one another has hobbled the efforts of ACOs to improve care and save money, says a report by Premier Inc. and eHealth Initiative. Meanwhile, a health care executive tells why her organization quit the Pioneer ACO program, and New York’s Mount Sinai urges a judge to dismiss a lawsuit tied to a rule requiring providers to return government overpayments within 60 days.

CQ Healthbeat: ACOs Complain Current Health IT Systems Thwart Cost Savings

The Obama administration boasts of successes launching accountable care organizations and fostering adoption of health information technology systems. But the two aren’t coming together the way they are supposed to in an effort streamline the delivery of health care. That was the complaint in a survey of ACOs jointly released Wednesday by Premier Inc., a hospital consortium, and the eHealth Initiative, a nonprofit whose members include doctor, patient, insurer, public health and other groups. ACOs aim to deliver team based care using health IT systems to coordinate treatment, share medical histories and test results and order tests and prescriptions with fewer errors. But the failure of health IT systems to work together seamlessly blocks these goals, said Premier Senior Vice President Keith Figlioli (Reichard, 9/24).

California Healthline: Why One Pioneer ACO Quit The Program – And What It Reveals About The ACA

Allison Fleury is the CEO of Sharp HealthCare’s accountable care organization. She’s a senior vice president at the health system, but was trained as a CPA. And the more she looked at Medicare‘s Pioneer ACO program — arguably the government’s most ambitious accountable care pilot — the more she worried that the numbers weren’t adding up for her organization, one of the 32 original Pioneers (Diamond, 9/24).

Modern Healthcare: Mount Sinai Urges Court To Dismiss Suit Tied To Repayment Rule

Mount Sinai Health System, one of New York City’s largest not-for-profit healthcare organizations, has asked a federal court to throw out a first-of-its-kind case that involves refunding overpayments to the federal government in a timely manner. Under a little-discussed provision of the Patient Protection and Affordable Care Act, providers must return all Medicare and Medicaid overpayments within 60 days of when the overpayments were identified. Failing to do so results in liability under the False Claims Act, which carries stiff penalties: up to $11,000 for each “fraudulently delayed” claim multiplied by three. Hospitals, physicians and healthcare attorneys have slammed the rule, saying it could hurt providers for unintended actions.  Mount Sinai’s legal battle could have ramifications for other health systems, according to Shannon DeBra and Beatrice Nokuri, healthcare attorneys with Bricker & Eckler (Herman, 9/24).

Failure of Health IT Systems Hinders ACO Cost Savings