How successful ACOs treat their physicians

June 17, 2020

What makes an accountable care organization (ACO) successful?

What makes an accountable care organization (ACO) successful?Researchers with the U.S Department of Health and Human Services conducted interviews with officials from the 20 top-performing ACO’s in the Medicare Shared Savings Program. The HHS officials asked the ACO leadership to identify the strategies they used to both improve care quality and cut costs.The top strategy identified: Working with physicians.Here are five ways the best ACOs work with physicians to improve patient care and cut healthcare costs.

1. Recruit physicians with a commitment to ACO goals

The most successful ACOS have physicians who:

Have experience meeting quality metrics and participating in alternative payments models.

Run practices that are recognized as patient-centered medical homes.

Are committed to using electronic health records, sharing data and improving care coordination strategies.

2. Provide data for physicians

Good ACOs provide:

Physicians with customized data to inform them about their practices performance and referral practices, especially in regards to the cost of services.

Individual physicians with regular spending and utilization reports. For example, one ACO provides data on the number of patients who visited the emergency department, in an effort to reduce avoidable visits.

Comparisons between physicians on their performance relative to their peers, including claims data.

Data on specialists, both inside and outside the ACO, to help physicians make informed referrals that take into account quality and cost. Some ACOs develop a list of preferred specialists and share it with their primary care doctors.

3. Highlight quality measures and gaps in care

Provide physicians with regular “report cards” about their performance on quality measures and any gaps in care, including information about patients overdue for preventive services such as cancer screenings.

Encourage the scheduling of annual wellness visits to address gaps in care.

Help physicians, to the best of the ACOs ability, stay up-to-date on frequently changing quality measures.

4. Redesign office workflows

Good ACOs provide physician practices with advice and help designing the most efficient office workflow possible.

Some ACOs integrate workflows into their practices’ EHR systems. For example, one ACO provides a dashboard that shows which patients need screenings.

5. Provide administrative and clinical support

High-performing ACOs often provide support staff to physician practices to help with appointment scheduling and refill requests.

Some ACOs provide clinical support in the form of performing preventive health screenings and creating patient summary reports before patients even see their physicians.