ACOs aim to expand reach in community, improve population health

After a rough year for Medicare Accountable Care Organizations, the ACO program aims to expand its population health management capabilities and strengthen ties with community providers.

Researchers from the Premier Research Institute used a grant from the Robert Wood Johnson Foundation to develop the first of a two-part series (.pdf) of reports. They conducted internet population health surveys, telephone interviews with ACO staff and an analysis of hospital population health efforts.

Most of the 19 ACOs studied participated in the Medicare Shared Savings Program, a commercial ACO or shared savings program. 

The review of their findings determined that of the ACOs analyzed, the vast majority were focused on improving care for high-risk patients and for specific high-risk conditions within their patient populations, such as asthma or chronic obstructive pulmonary disease.

A slimmer majority is working to provide access to patient-centered medical home (PCMH) models and improving outcomes, such as longevity and quality of life on a geographical basis. Less than half are working on improving non-medical factors associated with positive outcomes, such as food access and community safety, or aiding providers in becoming PCMHs.

Moreover, just under 1 in 3 respondents said their communities were sufficiently equipped to help improve community health, with hurdles including lack of staffing , time and funds, and pressure from insurers and physicians who still operate under the fee-for-service model. Going forward, ACOs aim to improve care through better information-sharing, clearer dialogue among provider, policymakers and funders, and a systemic framework that puts plans into motion based on ACO maturity and capability.

"Increasingly, providers understand how important the things that happen outside of the doctor's office or hospital are to improving and managing a person's health,” said Andrea Ducas, program officer at RWJF, in a statement. "To that end, some leading ACOs are expanding their services to include more upstream, preventive support for patients and are also expanding their work to reach entire communities, rather than just focusing on their assigned beneficiaries.”

“What can get lost in discussions is the impact of the social determinants of health on how well ACOs perform,” added Joe Damore, vice president of population health management at Premier. “This analysis reveals real-world efforts underway when it comes to the importance of community partnerships to influence health outcomes and performance. We’re seeing our members collaborate with organizations like Meals on Wheels to improve the health of their populations.”