The accountable care organization (ACO) model has seen substantial progress in recent years, but to succeed in the long term, the Next Generation ACO model must provide comprehensive data and engage with consumers, 12 consumer advocacy groups said in a letter to the Centers for Medicare & Medicaid Services (CMS).
To realize their potential, Next Generation ACOs must continuously improve, and the best way to ensure that is through collaboration with patients in care design and policymaking, according to the groups, which include the National Partnership for Women & Families, the Center for Medicare Advocacy, and the American Association on Health and Disability.
The financial incentives included in CMS' Next Generation ACO Model Request for Applications are a major potential obstacle to these goals, the letter states. When the model does employ financial incentives, they must be geared toward provider-beneficiary relationships, patient engagement and eliminating barriers to care. "We do not believe, however, that the currently proposed semi-annual monetary reward will achieve our shared goals of strengthened relationships between patients and their providers and enhanced patient engagement in their health and healthcare," the letter states.
The ideal Next Generation ACO will be able to improve patient experience as well as outcomes, according to the letter, and that requires partnerships with patients and their families, as well as the strongest possible consumer benefits and improved cost-sharing. Some aspects of the current CMS proposal advance that goal, including the proposed requirement that beneficiaries have access to their own medical records. Explicitly referencing electronic access would strengthen this even further, the groups write.
These considerations are particularly important as healthcare moves from a manufacturing model to a retail one, vastly increasing the importance of consumer focus, according to healthcare policy expert Paul Keckley, FierceHealthcare previously reported.
To learn more:
- here's the letter (.pdf)