Accountable care organizations can bolster efforts to drive value by seeking out partnerships with providers across the continuum of care, according to a new study that aims to establish a framework ACOs can use when evaluating potential partners.
Researchers with Leavitt Partners conducted a review of existing literature and convened a panel of experts to determine three elements ACOs should consider when building partnerships with providers.
- Assess the ACO's patient population. A clear picture of what kinds of patients are enrolled in an accountable care organization is crucial to determining if partnerships are needed outside traditional providers, and what to look for in those partnerships.
- Identify gaps and challenges. Once an ACO has a complete look at what their patients need, it can pinpoint gaps that can be solved by an outside partner. This will require studying the entire continuum of care and envisioning potential interventions to fully determine what skill sets are necessary.
- Determine the type of partner to fill those gaps. The study breaks down potential partners into groups, such as behavioral health or primary care, that ACOs can use to easily identify the best teammate.
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ACOs should consider several factors when deciding which partners will best address their needs, according to the study, published in Managed Care. There are seven "high-value" elements to look for in effective partners:
- Patient-centeredness
- A culture that emphasizes value
- Accountability
- A team-based approach
- High-functioning health information technology systems
- A quality assurance system
- Financial preparedness for value-based care
ACOs should also gather as much quality data and other relevant information for a complete picture of potential partners, though, according to the study.
"The principal consideration in an ACO's partnership strategy will be striking the balance between finding partners that can fulfill the needs of a dysfunctional American healthcare system (the status quo) versus those that will bring the most value in a quickly evolving system (the future state)," the research team wrote.
Policymakers can support ACOs in finding effective partners by continuing to ensure performance data is made available and that population assessment tools are constantly evolving. The Centers for Medicare & Medicaid Services' innovation center could also develop new payment models that push behavioral health providers, pharmacies and post-acute care providers to work alongside ACOs.
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Department of Health and Human Services Secretary Alex Azar has said that accelerating the transition to value-based care is a central goal for the agency under his leadership. His four-point plan includes using Medicare and Medicaid to lead the way while reducing the regulatory burden on providers who want to try new payment models.
The early years of Medicare ACOs produced mixed results, and many providers dropped out of the program due to the lack of significant savings. However, the programs turned a corner in 2016, with the Pioneer program earning $68 million in gross savings and the Medicare Shared Savings Program generating savings of $652 million.