After high-profile Next Generation exits, ACO model must adapt to survive

A series of high-profile problems may cast doubt on the future of accountable care organizations, but one leading healthcare policy expert believes the model isn't going anywhere and will continue to adapt to the market.

Despite high industry hopes for Medicare’s Next Generation ACOs, just last week three of the program’s 21 participants announced their exit. ACOs have come to embody the stop-and-go progress of transitioning to a value-based care system, Paul Keckley, Ph.D., writes for Hospitals & Health Networks.

Many organizations have had trouble implementing the model due to the major investments required, and by the same token, the most successful ACOs have involved larger organizations with a track record of successful risk-based payer arrangements, he says.

Meanwhile, for Next Generation ACOs to achieve success, they must rethink their approaches to clinical and organization frameworks, according to a separate H&HN article. For example, the Henry Ford Physicians ACO, one of only four Next Generation ACOs that weren’t part of the Pioneer or Medicare Shared Savings Program (MSSP), increased its commercial risk over the past few years and is now 30 percent value-based. Meanwhile, its clinically integrated network features a large population-health-focused medical group.

Similarly, North Carolina’s Cornerstone Health Enablement Strategic Solutions, an MSSP ACO that manages more than 16,000 Medicare patients, honed in on service lines to better integrate care and become more patient-centered, according to the article.

However, despite these goals, ACOs underperform in other value-based care programs, according to a study published in the American Journal of Managed Care. Researchers found no connection between ACO participation and improved scores on initiatives such as the Hospital-Acquired Condition Reduction and Hospital Value-Based Purchasing Programs.

“Organizations pursuing accountable care while also attempting to maximize performance on Medicare VBP [value-based purchasing] programs must recognize the different objectives of the programs and create strategies unique to each,” researchers wrote.

- read the first H&HN article
- here’s the second H&HN piece
- here’s the study abstract