Patients Are the "Missing Piece" for ACO Success

Industry experts discussed the big issues facing accountable care organizations (ACO) at the Brookings Institute’s event, The State of Accountable Care: Evidence to Date and Next Steps, held Monday in Washington, DC.

There are many challenges for hospitals that have become ACOs or are considering doing so, including engaging beneficiaries, payment formulas, combining ACO reforms with other payment reforms, and identifying best practices for clinical transformation.

Kelly Taylor, director of care management and quality at Mercy Clinics, explained that it was her organization’s drive to keep pushing forward even during the difficult times that made it become successful. Mercy’s Medicare ACO is participating in the Medicare Shared Savings Program and received a shared savings payment this year.

According to Ms Taylor, the physicians were the most difficult individuals to get on board when transitioning over to an ACO. In comparison, the patients were happy enough to make the change if it meant being more involved.

“Most patients want to be part of what’s going on in their life,” she said. “I think it’s a big reason why we’ve had issues with low medication adherence or low quality outcomes. The patient is really the missing piece.”

Patient engagement is one of the biggest concerns about ACOs, according to Jennifer Sweeney, vice president of the National Partnership for Women and Families. Although her organization has looked at ACOs as a benefit from the beginning, one issue is that they can devolve into just a financial mechanism instead of taking the time to truly transform care, she said.

“What I’m not seeing is collaboration between consumer organizations and ACOs,” Ms Sweeney said. “Consumer groups have expertise when it comes to communicating with patients and families.”

She added that consumer organizations, like her own, are open to working with ACOs to figure out these problems and lend a hand. For hospitals concerned about patients staying in an ACO, Ms Sweeney recommends avoiding marketing, which she called a “misguided approach.” There is no need to treat ACOs like a sales pitch when consumers are getting the kind of patient-centered care they want. Instead, she suggests building awareness through an educational approach.