Dr. Mike Deegan

Dr. Michael J. Deegan

A new online program recently launched by the Executive Education area in the Naveen Jindal School of Management teaches physicians and health care executives the fundamentals of designing, developing and operating an accountable care organization (ACO).

Over the past year, Dr. Michael J. Deegan, a clinical professor at the Jindal School, developed the Essential Elements of Accountable Care Organizations program, which began Jan. 23.

Many health care experts see the nontraditional, value-based delivery model of ACOs as a way to reduce medical costs and possibly increase physician income, said Deegan, a former physician and health care executive. He said while an ACO may entail increased financial risk for its backers, it also will secure higher-quality, more integrated care for patients via a model called patient-centered medical homes, which provide a more comprehensive set of primary care services by transforming their organization and delivery.

“I was approached some time ago by Blue Cross and Blue Shield of Texas President Dr. Dan McCoy, who at the time was the Texas plan’s chief medical officer,” Deegan said. “He asked if I would be interested in putting together what’s turned out to be this unique program that focuses on the fundamentals of accountable care.”

Through its foundation, Blue Cross and Blue Shield of Texas partnered with the Jindal School to fund 25 to 35 percent of the program’s development costs, Deegan said. After they agreed on a format, Deegan hired a professional videographer to create the content videos and built a course format that is similar to his online Healthcare Leadership and Management for Physicians Certificate Program.

Essential Objectives

The Essential Elements of Accountable Care Organizations course is intended to meet the following learning objectives:

  • Acquire the vocabulary, definitions and concepts applicable to ACOs and value-based medicine.
  • Become familiar with key ACO design elements.
  • Become acquainted with organizational and legal alternatives for ACOs.
  • Learn to recognize, assess and mitigate financial and clinical risks associated with ACO formation.
  • Be able to describe the key information technology, data analytics and performance-measurement requirements to assure ACO efficiency and effectiveness.
  • Examine the components of the value equation and learn to use each to enhance an ACO’s ability to provide high quality, cost-effective care.

“The course is intended, primarily but not exclusively, for interested physicians who are either contemplating starting an ACO or are already in a leadership role such as leader, co-leader, committee chair or board member,” Deegan said. “These ACOs are pretty sophisticated, and it takes somewhere between 18 and 24 months and between $1 million and $3 million of capital investment to start even a moderately sized one.”

In an ACO, some cost reductions can come from team-based care in which doctors delegate certain responsibilities of patient care to other team members.

“There are many things that physician assistants (PAs), nurses, and medical assistants can do in the care of a patient that don’t require a physician’s knowledge,” Deegan said. “The goal of everyone on the team is for everyone to work at the top of their license. In other words, doctors don’t do what PAs can do. PAs don’t do what nurses can do, and so on.”

Although it’s not known whether this model will actually reduce costs, Deegan thinks it will.

“I’ve worked in a system like that,” he said. “It’s much less fragmented than much of the care that’s currently being delivered, and you do get better care.”

About 20 physicians enrolled in the first course. Because Deegan wants to maintain a consistently high-quality product, future classes will not be much larger.

Elements of the course include critical leadership competencies; structural and functional elements; legal aspects of ACO formation; budgets, resource allocation and financial risk; performance metrics and information technology; clinical risk and population health management; and value-based care delivery.

The course is composed of eight units, each of which is introduced every three weeks and requires five to seven hours of work. The course takes about six months to complete.