By Margaret Sabin, President & CEO, Penrose-St. Francis Health Services; and Jeffrey Oram-Smith, M.D., CMO, Penrose-St. Francis Health Services

When it comes to Health Care Reform, we have three major principles that help guide us: 

Access:  We believe strongly in access for all. As a community benefit and a religious not-for-profit organization, we provide open access of our services and programs to all, regardless of their ability to pay. The amount of charity care we provide is the fastest growing segment of our budget. 

Financing:  We're focused on improving the value we deliver today to all Coloradans, and believe the economic rewards and penalties should be changed to align physician and health care system quality and economic incentives so we are working together to continually improve the effectiveness and efficiency of the care we provide.

Culture of Health:  We believe that genetics, the environment, and particularly lifestyle behaviors play a vital role in our health, and have a system commitment to "move upstream" and address health risks in a manner that prevents predictable diseases. 

The Patient Protection and Affordable Care Act of 2010 directs the Centers for Medicare and Medicaid Services to create a national voluntary program for Accountable Care Organizations (ACOs) by January 2012.

ACOs will be very important to Penrose-St. Francis Health Services because our patients benefit when a group of health care professionals work together to coordinate services.  ACOs will allow us to work closely with our physicians, both primary care and specialists, strengthening those relationships.

Many factors are coming together that call and compel us to work together more effectively in every area of our organization.  The most important of these factors is our patients. As we do the hard but rewarding work of collaboration, we must always keep those we serve at the forefront.

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By Lawrence McEvoy, M.D., CEO, Memorial Health System; Jonathan Velez, M.D., Chief Information Officer, Memorial Health System; and John Suits, Director of Business Development and Government Relations, Memorial Health System

Memorial fully accepts that Accountable Care Organizations (ACOs) represent the payment reform model for the future in health care, and we look forward to collaborating with our community physicians in embracing the concept. The tenets of the ACO model - patient-centered medical home, value-based purchasing, and a strong electronic health record - will redesign healthcare delivery systems as we know them.  These innovative delivery systems will be part of the solution to existing cost and quality problems. 

Electronic health records, in particular, are foundational for any effective ACO. This new level of connectivity among health care providers, patients and payers, alone, will help to drive cost out of the system by reducing repetitive services, enabling chronic disease management, and promoting wellness and prevention. 

 At the same time, we at Memorial realize the expense could not come at a worse time for struggling physicians.

Memorial Health System and Penrose-St. Francis Health Services, in light of the challenges our independent physician partners face, have been exploring the possibility of subsidies. Both health systems are participants in the Colorado Regional Health Information Organization, or CORHIO. While these conversations have not yet determined dollars and rules for such subsidies, the goal is to create the most comprehensive exchange for patient records in the most cost-effective way.

CORHIO is an information highway that connects medical providers across Colorado. While there are many ways for hospitals and physicians to connect, CORHIO seems to provide the most flexibility for providers who have different kinds of EMR systems. Hospitals and physicians invest in the connection, rather than a particular software that all must agree to use. This provides the most flexibility and choice for physicians and other organizations who have already invested in EMRs. Moreover, it allows greater access to records anywhere in Colorado, not just your local physician network.