Nav: Home

Learning on the job: Johns Hopkins Medicine Alliance for Patients

December 14, 2015

Academic medical centers that take on community partners to form accountable care organizations face a number of unexpected challenges, says Scott Berkowitz, M.D., M.B.A., medical director of accountable care for the Office of Johns Hopkins Physicians and executive director of the Johns Hopkins Medicine accountable care organization (ACO) known as the Johns Hopkins Medicine Alliance for Patients (JMAP).

Twenty-two months after the inception of JMAP, Berkowitz and colleagues report on the startup experience in a "Perspective" article published recently in the journal Academic Medicine.

Information technology challenges, governance issues and provider engagement hurdles are among the barriers academic medical centers can expect when partnering in accountable care ventures, Berkowitz says.

"We've learned a lot in the first year-and-a-half of our ACO," Berkowitz says. "Changing our focus from one based on volume to one based on value requires some new ways of thinking. We're glad to share some of our initial findings."

JMAP is made up of the Johns Hopkins University School of Medicine, Johns Hopkins Community Physicians, The Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center, Howard County General Hospital, Suburban Hospital and Sibley Memorial Hospital. JMAP partners include Columbia Medical Practice, Potomac Physician Associates and Cardiovascular Specialists of Central Maryland. In all, nearly 2,900 providers care for 37,000 Medicare beneficiaries.

"We have been thrilled to be members of the JMAP team," says DeWayne Oberlander, CEO of Columbia Medical Practice. "Partnership in an ACO with Johns Hopkins has created the relationships and processes that have fundamentally changed the referral process and established the structure for collaborative working relationships. It is amazing to consider how far we've come, and we're looking forward to the important work ahead to improve the quality and efficiency of care."

In this piece, Berkowitz focused on academic medical centers in the Medicare Shared Savings Program, the most common type of ACO.

The generation and collection of data, Berkowitz says, were among the challenges Johns Hopkins Medicine faced in the early days of its ACO.

Both Johns Hopkins and its community partners in the ACO were in various stages of electronic medical records implementation. Training systems to communicate with one another is integral to long-term ACO success.

"The steps to receiving Medicare claims data and then the ability to use the data for analysis and risk prediction have taken nearly a year to implement," Berkowitz writes in the report. "Although one would hope to be able to leverage these powerful tools early on in the first performance year, the reality is that the complexity of systems can take time to properly navigate, and there is a need for upfront IT, analytic and electronic medical record expertise."

The ACO was a keystone of the Affordable Care Act, encouraging providers and hospitals to form networks that coordinate efficient patient care, keeping Americans healthier and reducing health costs at the same time. More than 7.2 million Medicare beneficiaries are covered by 405 Shared Savings Program ACOs across the U.S.

Berkowitz also points to the inherent tension for academic medical centers in moving to a population health model.

"Maintaining specialty referrals and a high hospital bed occupancy rate can still be consistent with the overall philosophy of keeping people healthy and out of the hospital when appropriate," Berkowitz says. "The goal is the right care, in the right place, at the right time."

The U.S. Department of Health and Human Services has said that a target of 30 percent of Medicare payments will be tied to quality or value through alternative payment models such as ACOs by the end of 2016 and that, by the end of 2018, one-half of payments will have this requirement.
-end-


Johns Hopkins Medicine

Related Health Articles:

Mental health of health care workers in china in hospitals with patients with COVID-19
This survey study of almost 1,300 health care workers in China at 34 hospitals equipped with fever clinics or wards for patients with COVID-19 reports on their mental health outcomes, including symptoms of depression, anxiety, insomnia and distress.
Health records pin broad set of health risks on genetic premutation
Researchers from the University of Wisconsin-Madison and Marshfield Clinic have found that there may be a much broader health risk to carriers of the FMR1 premutation, with potentially dozens of clinical conditions that can be ascribed directly to carrying it.
Attitudes about health affect how older adults engage with negative health news
To get older adults to pay attention to important health information, preface it with the good news about their health.
Geographic and health system correlates of interprofessional oral health practice
In the current issue of Family Medicine and Community Health (Volume 6, Number 2, 2018, pp.
Bloomberg era's emphasis on 'health in all policies' improved New Yorkers' heart health
From 2002 to 2013, New York City implemented a series of policies prioritizing the public's health in areas beyond traditional healthcare policies and illustrated the potential to reduce cardiovascular disease risk.
Youth consider mobile health units a safe place for sexual health services
Mobile health units bring important medical services to communities across the country.
Toddler formulas and milks -- not recommended by health experts -- mislead with health claims
Misleading labeling on formulas and milks marketed as 'toddler drinks' may confuse parents about their healthfulness or necessity, finds a new study by researchers at the NYU College of Global Public Health and the Rudd Center for Food Policy & Obesity at the University of Connecticut.
Women's health has worsened while men's health has improved, trends since 1990 show
Swedish researchers have studied health trends among women and men aged 25-34 from 1990-2014.
Health insurance changes, access to care by patients' mental health status
A research letter published by JAMA Psychiatry examined access to care before the Patient Protection and Affordable Care Act (ACA) and after the ACA for patients grouped by mental health status using a scale to assess mental illness in epidemiologic studies.
Community health workers lead to better health, lower costs for Medicaid patients
As politicians struggle to solve the nation's healthcare problems, a new study finds a way to improve health and lower costs among Medicaid and uninsured patients.
More Health News and Health Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Teaching For Better Humans 2.0
More than test scores or good grades–what do kids need for the future? This hour, TED speakers explore how to help children grow into better humans, both during and after this time of crisis. Guests include educators Richard Culatta and Liz Kleinrock, psychologist Thomas Curran, and writer Jacqueline Woodson.
Now Playing: Science for the People

#556 The Power of Friendship
It's 2020 and times are tough. Maybe some of us are learning about social distancing the hard way. Maybe we just are all a little anxious. No matter what, we could probably use a friend. But what is a friend, exactly? And why do we need them so much? This week host Bethany Brookshire speaks with Lydia Denworth, author of the new book "Friendship: The Evolution, Biology, and Extraordinary Power of Life's Fundamental Bond". This episode is hosted by Bethany Brookshire, science writer from Science News.
Now Playing: Radiolab

Dispatch 3: Shared Immunity
More than a million people have caught Covid-19, and tens of thousands have died. But thousands more have survived and recovered. A week or so ago (aka, what feels like ten years in corona time) producer Molly Webster learned that many of those survivors possess a kind of superpower: antibodies trained to fight the virus. Not only that, they might be able to pass this power on to the people who are sick with corona, and still in the fight. Today we have the story of an experimental treatment that's popping up all over the country: convalescent plasma transfusion, a century-old procedure that some say may become one of our best weapons against this devastating, new disease.   If you have recovered from Covid-19 and want to donate plasma, national and local donation registries are gearing up to collect blood.  To sign up with the American Red Cross, a national organization that works in local communities, head here.  To find out more about the The National COVID-19 Convalescent Plasma Project, which we spoke about in our episode, including information on clinical trials or plasma donation projects in your community, go here.  And if you are in the greater New York City area, and want to donate convalescent plasma, head over to the New York Blood Center to sign up. Or, register with specific NYC hospitals here.   If you are sick with Covid-19, and are interested in participating in a clinical trial, or are looking for a plasma donor match, check in with your local hospital, university, or blood center for more; you can also find more information on trials at The National COVID-19 Convalescent Plasma Project. And lastly, Tatiana Prowell's tweet that tipped us off is here. This episode was reported by Molly Webster and produced by Pat Walters. Special thanks to Drs. Evan Bloch and Tim Byun, as well as the Albert Einstein College of Medicine.  Support Radiolab today at Radiolab.org/donate.