3 traits of successful ACOs: A focus on internal culture, population health and continuous improvement

Patient and nurse in hospital
Successful ACOs offer key lessons for providers looking to jump into accountable care. (Getty/monkeybusinessimages)

Forming an accountable care organization is one of the most common strategies healthcare organizations use to transition to value-based care, and several key characteristics and tactics from the most high-performing ones can help other providers build their own successful programs, according to a new report. 

The Health Care Transformation Task Force studied 11 ACOs across the country by interviewing key decisionmakers at those organizations, identifying three "levers" that are central to a successful ACO: 

  1. Build a culture that is conducive to value-based care.
  2. Embrace population health management.
  3. Establish the ACO on a foundation that supports continued improvement. 

RELATED: How NYC Health + Hospitals found ACO success, reducing Medicare costs and earning millions in savings 

These three elements can be used to help new or established ACOs prioritize improvement goals and measure efficiency of existing processes, according to the task force's report. 

“The greatest driver of future ACO growth will be the success of existing ACOs, as fence-sitting providers will be swayed by participants’ achievements or failure, as well as the positive evolution of the ACO model,” Danielle Lloyd, vice president of policy and advocacy for healthcare improvement company Premier and a member of the task force's executive committee, said in an announcement (PDF). 

Within each of the broader levers, the report offers strategies that providers can use to address gaps in those areas. For example, engaging physicians is central to building an internal culture that fosters value, so ACOs must build projects with their input and create actionable measures to monitor progress. 

An executive at one hospital-led ACO said the facility works to hire people who can fit into that cultural vision, according to the report. 

“It requires a very passionate on-the-ground team to keep people focusing on these things," the executive said. "And so we hire people specifically who have that passion and that vision to work on the accountable care services team.” 

RELATED: Physicians feel sidelined in value-based care discussion 

Population health management and an improved performance structure both require extensive use of data and analytics, according to the report. Patient data is central to population health initiatives, as it can be used to monitor trends and manage complex, chronic conditions. 

One executive at an integrated ACO said that their facility deployed quality coordinators to monitor performance, but at the outset these staffers spent most of their time collecting data instead of monitoring it. So leadership developed a new system to gather better data at billing so that these employees could focus on their quality improvement projects.