When insurers and providers create new accountable care organizations, there are certain considerations they should keep in mind to help guarantee the programs' success, according to a new blog post in Health Affairs.
One of the biggest problems in setting up a new ACO is that neither payers nor providers can appropriately invest in necessary features, including technology and personnel, without guaranteeing participants will see meaningful, measurable gains in their care, as well as lowered costs.
To help insurers and providers implement critical features that often lead to successful ACOs, the Catalyst for Payment Reform and the Pacific Business Group on Health released an ACO toolkit with some valuable lessons learned.
Here are several suggestions from the toolkit:
1. Be selective about the provider network: When insurers develop ACOs, they should be selective about which providers they collaborate with. Insurers should always have an eye toward working with providers that deliver high quality and efficiency--providers interested in participating ACOs should be mindful of meeting such measures.
2. Measure outcomes: Since ACOs aim to improve quality and reduce costs, insurers and providers must generate outcomes measures so they can determine the partnership's impact on quality and costs.
3. Support care management: Providers must support targeted care management if they're to participate in ACOs. Successful ACOs also tend to have doctors who engage in shared decision-making with patients.
4. Share data: Sharing cost and quality information between insurers and providers is one of the key benefits to ACOs. That's because sharing as much information as possible helps providers improve their performance and boost quality. Meanwhile, payers must require that providers are transparent about spending and savings distribution within the ACO.
5. Incorporate technology: To track care management and outcomes measures, some sort of health technology is required within an ACO. That's why payers and providers should invest in technology to ensure improvements.