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Pioneer ACO Atrius Health Focuses on Clinical & Business Intelligence within its Six Practice Groups

CHICAGO (January 31, 2013) – Second in its series on clinical and business intelligence, HIMSS Analytics published a new white paper, “Atrius Health, Pioneer ACO, Clinical Intelligence & Business Intelligence,” released in January 2013.

Atrius Health, one of 32 organizations selected in 2011 by the Centers for Medicare and Medicaid Services for its Pioneer Accountable Care Organization program, is a nonprofit alliance of six multi-specialty medical groups. It was created in 2004 to enable collaboration on new and better ways of delivering care, transform the delivery of health care in eastern and central Massachusetts, while maintaining an emphasis on care for the local community. The staff of over 7,200 employees includes 1,000 physicians and more than 1,425 healthcare professionals who service 3.8 million visits from over one million adult and pediatric patients at some 50 sites cross Eastern and Central Massachusetts.

HIMSS Analytics worked with Atrius Health to present its unique perspective on how the organization approached management and delivery of care to assigned beneficiaries. This white paper provides a benchmark of the approach Atrius took to manage two critical components of its Pioneer ACO: clinical and business intelligence.

Clinical Intelligence with Atrius Health – as a Pioneer ACO: The Atrius Pioneer ACO program has been assigned and services approximately 55,000 Medicare Advantage patients with about 70 percent of its revenues from risk-based patient populations. With that in mind, Atrius developed its own approach to managing these populations.

“We also adopted a relatively unique concept in that we wanted to take care of all of our patients exactly the same, no matter what their funding mechanisms were. So we’ve combined our ACO population with our Medicare Advantage population,” says Dr. Gene Lindsey, CEO, Atrius Health, in the white paper.

The organization has two primary goals for clinical intelligence:

  • To reduce Atrius Health’s cost to two percent under the official Medicare “reference population” trend, allowing Atrius Health access to its earned savings, which bends the cost curve two percent relative to the baseline population; and
  • To effectively report on the 33 quality metrics required of all Pioneer ACOs from the Innovation Center.

With these goals in mind, Atrius hired an ACO Executive Director to coordinate and manage the interaction between participating organizations and facilitate Pioneer ACO efforts. The executive director then established clinical workgroups to focus on four areas:

  • hospital strategy;
  • post-acute facility strategy;
  • home care strategy; and
  • geriatric care model design.

Each workgroup established its own goals, but used common reporting and benchmarking standards to ensure accountability for the workgroup and the overall ACO patient focus. Then, to build and sustain momentum, Atrius Health also established a monthly event called “ACO Day,” where all clinical leaders come together for a half day meeting with updates on current activities, separate workgroup meetings a learning collaborative with best practice presentations and discussions on a specific topic.

Business Intelligence with Atrius Health – as a Pioneer ACO: The provider groups at Atrius Health pay a fee for centralized IT services, thus enabling efficient IT management and economies of scale for pricing and support. As indicated in the white paper, the centralized approach also allows for investment in tools that increase value of the data, a benefit not possible with data and funding segregated by provider practice or facility location.

“Anything that we do clinically has to be supported with the business, both with an operationally efficiency and cost perspective, but as well with patient experience,” says Dr. Joe Kimura Medical Director of Clinical Reporting and Analytics, Atrius Health.

Dr. Kimura thus identified four primary business markets, beyond the 33 quality measures all Pioneer ACOs must report.  Each of these markets – executive team/external partners; director and site-based administrators; physician and line managers; and patients – has a different level of maturity as well as needs for different types of data and access.  The white paper reviews these markets and details current and planned-for business intelligence activities at Atrius Health.

In managing its Pioneer ACO capabilities, Atrius Health has: 1) leveraged its physician practice expertise; 2) developed a centralized and supportive IT department with a complete EMR and supporting data warehouse; 3) used strong communication and internal coordination; and 4) worked with its external partners, including hospitals and skilled nursing facilities, to set consistent standards, for normalized patient care with other organizations, to reach patients wherever they need care.

“The Atrius Health ACO provides a good contrast to our research and publication on how Banner Health approached clinical and business intelligence within the Pioneer ACO program.  The organizations are quite different in focus, size, mission, and of course, the IT capital and resources they can access. Atrius Health uses astute negotiating with care partners combined with simple IT-based care coordination solutions to affect a dramatic, yet practical, impact on their ability to leverage clinical and business intelligence,” says James Gaston, Senior Director, Clinical and Business Intelligence, HIMSS Analytics.

Read Atrius Health, Pioneer ACO, Clinical Intelligence & Business Intelligence,the second white paper in the Pioneer ACO series from HIMSS Analytics.

About HIMSS Analytics

HIMSS Analytics is a wholly owned not-for-profit subsidiary of the Healthcare Information and Management Systems Society. The company collects and analyzes healthcare data related to IT processes and environments, products, IS department composition and costs, IS department management metrics, healthcare trends and purchase-related decisions. HIMSS Analytics delivers high quality data and analytical expertise to healthcare delivery organizations, healthcare IT companies, state governments, financial companies, pharmaceutical companies, and consulting firms.  Visit for more information.

February 8, 2013 I Written By

John Lynn is the Founder of the blog network which currently consists of 5 blogs containing over 11,000 articles with John having written over 5500 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 18 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Physician Health Partners, CO-REC Helping Physicians Demonstrate Meaningful Use of Electronic Health Records

Dr. John McLaughlin among state’s first doctors to reach this milestone in healthcare quality and reform

Collaborative efforts between Physician Health Partners and the Colorado Regional Extension Center (CO-REC) are proving successful at helping Colorado physicians implement electronic health record (EHR) systems to improve patient care and qualify for special federal government incentives for adopting health IT.

EHRs reduce or eliminate the need for paper medical charts, and improve access to patient-specific health information. Health care policy makers believe the widespread use of EHRs will play an important role in improving the quality and affordability of health care services. Special Medicare and Medicaid reimbursement payments provided by the federal stimulus bill incent physicians to invest in EHRs by partially subsidizing their cost. To qualify for the government incentives, they must demonstrate Meaningful Use by meeting a set of requirements, as defined by the Centers for Medicare and Medicaid Services (CMS). To achieve Meaningful Use, it takes months of process changes and implementation by the physicians and staff.

Dr. John McLaughlin, a family physician in Aurora, Colo. is among the first physicians in the state, and one of few in the country, to complete this process and make strides toward seamless healthcare delivery for his patients. McLaughlin began using the Ingenix CareTracker EHR system in August 2010. Physician Health Partners (a partner organization with CO-REC), along with Ingenix, provided essential training and one-on-one support to McLaughlin and his staff until they successfully met Stage 1 Meaningful Use criteria on May 1, 2011.

“Physician Health Partners and Ingenix provided me with the support and advice I needed to leave paper records behind,” said McLaughlin. “EHRs were created to support physicians in improving healthcare for their patients, but many physicians have legitimate concerns about the cost and disruption of making the switch. With the right technology, Ingenix CareTracker, and the support from Physician Health Partners and CO-REC, we’ve completed our transition in less than one year. I’ve seen how the EHR helps me to provide better care to my patients.”

Through federal American Recovery and Reinvestment Act (ARRA) funding, CO-REC services are designed to help more than 2,200 eligible primary care providers in Colorado qualify for Medicaid and Medicare incentive payments now through 2012. CO-REC assists primary care providers in adopting, implementing and becoming meaningful users of EHR systems to qualify for federal stimulus funds. While the primary goal of CO-REC is to serve health care providers in Colorado, the ultimate goal is to improve the quality of health care for all Colorado patients.   Physician Health Partners is one of six partners with CO-REC working to educate and implement EHRs in medical practices.

To learn more about the Meaningful Use criteria, visit

About Ingenix CareTracker

Ingenix CareTracker is a family of cloud-based services that enable physicians to enhance patient care and manage their practices more efficiently. The Ingenix CareTracker system includes a CCHIT Certified 2011 Ambulatory EHR and ONC-ATCB 2011/2012 Certified solution that saves physicians time and money by helping them access clinical information and patient medical history at the point of care. Ingenix CareTracker features connections to thousands of labs, hospitals, pharmacies and commercial and government payers. The system helps physicians conduct medication and allergy verification and interaction checks, electronic prescribing, and quality measurement and reporting. Ingenix CareTracker also fully integrates with all of the operational functions of a physician practice, simplifying administrative tasks such as billing, scheduling and documentation.

About Physician Health Partners

Physician Health Partners (PHP) is an integrated team of physicians and healthcare professionals committed to supporting effective patient care throughout the healthcare continuum. Founded in 1996 as a management services organization, PHP believes physicians and other providers have the capability and responsibility to drive high quality, cost-effective healthcare for patients. Through our robust Clinical Quality Improvement Services and diverse medical management solutions, PHP works tirelessly to support primary care physicians in improving clinical outcomes for the benefit of the patient. By improving clinical outcomes, enhancing provider performance and developing practice efficiencies, patients’ health status is improved and overall healthcare costs are reduced.  For more information, visit


CO-REC, an initiative of CORHIO, received ARRA funding to create the Colorado Regional Extension Center (CO-REC), to assist primary care physicians in small practices, and other safety providers across the state with achieving meaningful use. Nearly 1,800 providers and 24 hospitals are actively engaged with a CO-REC partner today to meet the Stage 1 Meaningful Use criteria. CO-REC’s six partner organizations, dedicated to healthcare improvements in Colorado, include: Colorado Foundation for Medical Care, Colorado Rural Health Center, Colorado Community Managed Care Network, Health TeamWorks, Physician Health Partners, and Quality Health Network. For more information on CO-REC visit

May 23, 2011 I Written By