Why policymakers should consider ACOs' 'unique' paths to success

Medicine Money
A new survey dives into the "unique" paths affordable care organizations are taking. (Getty/utah778)

Affordable care organizations are finding their own paths to success—and industry stakeholders should consider those unique needs as they shape policy, according to a new survey. 

Leavitt Partners and the National Association of Accountable Care Organizations (NAACOs) released their second annual ACO survey, which polled 203 organizations on challenges and priorities in their participation. 

The survey found many ACOs want to stay the course and not change their approach to the model. For example, of those considering or already participating in a contract with downside risk, 59% said they would likely continue in the program if forced to take on more risk. 

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By contrast, 66% of ACOs that were not in a risk-bearing contract or considering one said they were likely to quit the program if pushed into greater risk. 

“I think the takeaway from that is ACOs are on their chosen path, whether that includes risk or not,” Kerstin Edwards, research partner at Leavitt Partners and one of the report’s authors, told FierceHealthcare. 

RELATED: Why hospital associations are dipping their toes in to state-based Medicare ACOs 

The survey also highlights the contrast between physician-led and hospital-based ACOs, which have unique structures and set very different goals and priorities. The majority of physician-led ACOs (65%) were likely to stick with the program if pushed to take on greater risk, compared to 31% of hospital-led ACOs. 

Hospital and health system ACOs were far more focused on lowering post-acute care spending than their physician-led counterparts, according to the survey. Half said they were prioritizing that area, compared to 21% of physician-led ACOs. 

ACOs led by doctors, however, were focused on lowering unnecessary emergency department visits and costs. The vast majority (81%) said this was a key goal, compared to 57% of hospital-led ACOs. 

More than half of physician-led ACOs (65%) also said they were prioritizing reduced readmissions through improved care transitions, compared to 42% of hospital-led organizations. 

RELATED: Considering becoming an ACO? These are the common traits of those most likely to succeed 

Robert Richards, Ph.D., a senior data analyst at Leavitt Partners and one of the report’s authors, told FierceHealthcare these findings demonstrate the need for greater information sharing between ACOs, policymakers and other stakeholders on what’s working and what’s not, including more individualized needs. 

ACOs also can benefit strongly from having a role model to follow so they’re not “reinventing the wheel” by entering the program, and that’s made even more effective when those role models can share their more unique approaches or concerns, he said. 

“It just highlights the need at this point … to sort of diffuse learnings and really help ACOs learn from each other what works,” Richards said. 

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