Embarking on accountable care: preparing for the second curve.

With the advent of the Affordable Care Act, new models of care are underway. Health care experts agree that to improve care, there will need to be improved partnerships across the care continuum, finally eliminating silos of care and services. WellStar Health System, a large health care system in the southeastern part of the United States, is demonstrating its early adoption of integration and the new rules of engagement. These rules will fundamentally change the course of how to provide health care and lead the way for a more accountable-based model of care delivery. This article describes the anticipated and successful preliminary outcomes achieved in the first year of this system's demonstration project in the Medicare Shared Savings Program or "Medicare ACO." WellStar Health System began with a focus on addressing the needs of the heart failure patient. In an effort to achieve the triple aim of improving access, reducing cost, and improving outcomes, the system designed a dedicated inpatient heart failure unit. This unit operates with a new and sustainable structure that actually links the interdisciplinary and multiple providers of care across the care continuum. In doing so, a significant improvement in achieving patient's compliance with care treatment and a reduction in hospital readmissions have been achieved.