Gaps found in ACOs' use of medications to meet goals

A study to evaluate whether accountable care organizations (ACOs) are prepared to maximize the value of medications to achieve quality benchmarks and cost offsets found high readiness in some areas, but have room for improvement in others.

The study, conducted through a partnership between the National Pharmaceutical Council (NPC), the American Medical Group Association (AMGA) and Premier, is published in the Journal of Managed Care Pharmacy.

It's part of a broader project to help ACOs understand the role of pharmaceuticals in achieving their financial and quality goals.

"We've long known that optimal use of medications can be an effective tool in meeting the goals of managing costs and improving quality. We set out to determine whether ACOs are poised to maximize the value of medications to achieve those goals," NPC Chief Science Officer Robert W. Dubois, MD, one of the article's authors, said in an announcement. "What we found was that ACOs have not yet achieved this integral and critical component of care."

Based on survey responses from 46 ACOs, it found positive indicators included the ability of ACOs to:

  • Transmit prescriptions electronically (70 percent have high readiness in this area)
  • Integrate medical and pharmacy data into a single database (54 percent)
  • Offer formularies that encourage generic use when appropriate (50 percent)

The organizations, however, were just beginning to address these capabilities:

  • Notify a physician when a prescription has been filled (Nine percent)
  • Have protocols in place to avoid medication duplication and polypharmacy (17 percent)
  • Have quality metrics in place for a broad diversity of conditions (22 percent)
  • Quantify the cost offsets of medication use and demonstrate the value of appropriate medication use (Seven percent have high readiness in this area)

The first phase of the broader project, published in July 2012,  focused on developing a framework for ACOs to consider the costs and benefits of medications in meeting their goals. This study focused on organizational readiness and gaps to be filled. Further work will be devoted to developing practical tools to help ACOs fill those gaps.

The number of Medicare ACOs is growing faster than non-Medicare contracts, yet the systemic changes involved when a medical group enters an ACO-related contract with a payer spill over, producing savings in care for Medicare patients as well, a recent study found.

Hennepin County Medical Center in Minnesota reports its ACO medication management program has helped cut admissions by 42 percent, emergency room visits by 37 percent and an average cost of care by $2,500 per patient.

To learn more:
- find the study
- read the announcement