Background

The passage of health care reform has set into motion a number of efforts to create different models and approaches for providing comprehensive, coordinated, and cost effective care. Accountable Care Organizations (ACO’s) appear to be the most popular model being pursued. While the new health care law sets forth some broad goals for what an ACO should accomplish, specific regulations on how ACO’s are to work in practice have yet to be developed.

In South Los Angeles a number of different entities are working to develop their individual versions of an ACO. Clearly, successful development of one or more ACO’s could be beneficial to residents of the area. But even greater benefit could be derived if a process could be developed and implemented whereby residents could be assured that no matter which ACO serves them, their medical histories and records would always be available to the appropriate care provider. Historically, fragmentation and shifting provider systems have resulted in duplication of services, tests, procedures and visits when patients are faced with yet another new source of care. Opportunities for efficiencies are evident.Similarly, having an agreed upon set of quality metrics adopted by each individual ACO could demonstrate how their collective efforts have improved the health status of south central residents. Equally exciting is the prospect that some major demonstration project(s) resulting from collaboration among ACO’s could be developed and potentially serve as models for other major metropolitan areas across the nation.

Overview of project

The California Endowment has retained National Health Foundation (NHF) to serve as the lead organization to assist in the development and implementation of a planning effort designed to create a vision with measurable goals, objectives and implementation strategy for an integrated delivery network (IDN) for South Los Angeles.

NHF has identified three key areas which could facilitate “integrating” the individual efforts being undertaken. These include measuring quality, assuring electronic connectivity, and identifying innovative demonstration projects. As a result of a commitment from the Watts Health Foundation and The California Endowment, approximately $20 million dollars is available to assist key stakeholders in accomplishing the goal of developing an integrated delivery system for South Los Angeles.

Timeline

Over the next 18 months a series of tasks will be initiated. These include: 1) a survey completed via in-person interviews of 20-30 key stakeholders to better understand the goals and objectives of the various ACO’s currently in development and how an integrated delivery network can best be implemented, 2) a convening of the key players involved in developing ACO’s in south central to create the opportunity to learn what the others are attempting to accomplish, and 3) a series of quarterly task force meetings designed to identify how best to develop and implement ways to assure inter-operability (e.g. electronic connectivity), measure quality, identify what financial assistance could be made available and identify a significant innovative demonstration project(s) that could be implemented. A web-based system which will allow stakeholders in South Los Angeles to pose questions, and receive systematic feedback from the task force work groups has been developed. Prior to each work group, stakeholders will have the opportunity to pose questions and/or identify issues they would like the task forces to address. Results of each task force meeting will be posted on a project web site. Any interested party will have access to the proceedings of each task force meeting.

How is this different than other projects?

NHF’s task is not to create an ACO or structured delivery system of healthcare but rather to design a process with those who are doing so to facilitate “integration” of key components across the various developing ACO’s to support coordinated comprehensive system of care for all of the residents of South Los Angeles.

Why National Health Foundation?

National Health Foundation is an independent 501(c)3 non-profit organization striving to increase access to healthcare. NHF is not a business stakeholder in South Los Angeles and has no loyalties to the success of specific projects, only to the improvement of health for the South Los Angeles Community.

Last updated 1 July, 2011