Episode #144 is a discussion with Dean Gruner, MD, the president & CEO of ThedaCare, talking about Accountable Care Organizations  (ACOs) and how ThedaCare is using this approach, along with Lean methods, to improve the coordination of care for patients. Dean was  previously a guest in episode 119, talking about the “strategy deployment” methodology.

Dean will be presenting at the upcoming Lean Healthcare Transformation Summit, June 6-7, 2012 in Minneapolis. I hope to see you there! I'll be attending and moderating the CEO panel again this year.

For a link to this episode, refer people to  www.leanblog.org/144.

For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

Mark Graban: Hi, this is Mark Graban. Welcome to the podcast, episode 144 for April 16th, 2012. My guest today is Dr. Dean Gruner. He is the CEO of ThedaCare. He was previously a guest on episode 119 talking about “strategy deployment” as part of their management system at ThedaCare.

Today, we're going to be talking about ACOs or Accountable Care Organizations and how that fits in with a Lean perspective at ThedaCare, related to healthcare reform happening here in the United States. Dr. Gruner is going to be presenting at the “Lean Healthcare Transformation Summit,” June 6th and 7th in Minneapolis.

This is an event that's co-sponsored by the Lean Enterprise Institute and the ThedaCare Center for healthcare Improvement. I'll be there. I'll be attending. I'm going to be moderating the CEO panel again this year. I certainly hope to see you there. It's a great event, wonderful speakers from the healthcare value network organizations, just a lot of great attendees, networking, learning and sharing.

You can visit leanblog.org/healthcaresummit and that will forward you to the official conference website to learn more and to register. For other episodes, you can go to leanpodcast.org and for Dr. Gruner's previous episode, go to leanblog.org/119.

Thanks for listening.

[music]

Mark Graban: Dean, it's a pleasure to talk to you again. Thanks for joining us here on the podcast.

Dr. Dean Gruner: Thanks, Mark, for inviting me.

Mark: I think a lot of our listeners, especially those outside of healthcare and maybe even some within healthcare might not know a lot about ACOs or “Accountable Care Organizations.” Would you mind giving us a little bit of an intro about what an ACO is?

Dr. Gruner: I'll try. I think the short version is that, there are multiple definitions out there. Everybody has a little different description of what an ACO is. I think of it as a mechanism for a group of providers, whether it's a group of physicians, physicians at hospitals, hospitals or healthcare systems, to be accountable for both the quality and the cost of the care that they are providing to a group of patients.

An example today that people might be familiar with is Kaiser. Kaiser provides the premium in their case, but they only provide premium for their health insurance, but then they become accountable for providing all the services that that person would need under the Kaiser umbrella. All ACOs aren't just models like Kaiser, which is what we would call a staff model HMO.

There may be groups of physicians in hospitals and other care providers that come together, again, for the purpose of providing the services to patients and assuming some degree of accountability for both the quality of the care that's provided and the cost of the care that's provided.

Mark: Part of the idea, if we look at this from a Lean perspective, when you talk about improving quality and cost which, people familiar or experienced with Lean would realize it's possible to do both.

Where do these improvements come from? Is it a matter of better coordination between hospital care or primary care.? How do people in different organizations collaborate in an ACO? What are the types of benefits that we're expecting to see?