Report: 10 things to know about accountable care

Big changes were made on the ground level of accountable care organization (ACO) activity this week. While the final ACO rule was released Oct. 20, a report from the Institute for Health Technology Transformation released this week outlined generalizable ACO characteristics and recommendations to providers interested in applying for ACO status.

The report, “ACOs: 10 Things You Need to Know About Accountable Care,” stated that regardless of structure, an ACO will ideally exhibit characteristics including:

• Care management policies that encourage collaboration across the continuum of care;
• Patient-centered practices that engage and empower the patient;
• Health IT that collects, organizes, compiles and reports both clinical and financial data;
• Infrastructure that facilitates communication and cooperation among departments and across the care continuum;
• Culture of service and patient care excellence; and
• Mechanisms for savings so that clinicians can provide high-quality, evidence-based care that also contributes to organizational profitability.

According to the report, start-up cost estimates vary widely. The Centers for Medicare & Medicaid Services (CMS) estimated costs of approximately $1.7 million per ACO while the American Hospital Association figures ranged between $5.3 million and $12 million.

The New York City-based organization noted that patient engagement, data aggregation, population health management and reporting infrastructure were important factors to consider in regards to technology. “Any organization looking to become an ACO must accurately assess its current IT capabilities and what IT assets will be required to realize shared savings,” the report stated.

According to the report, there are ten things to know about ACOs:

1. The role of the physician will change dramatically.
2. Patients must be engaged in their care.
3. ACOs will create winners and losers among providers.
4. ACOs are a team sport.
5. Transparency will empower consumers and motivate providers.
6. ACOs will require health system redesign—not just tinkering with payment models.
7. ACOs must be a dynamic learning organization.
8. An ounce of prevention is worth a pound of cure—and costs a lot less.
9. Expect a significant change in transitions of site care and delivery mechanisms. Remote and virtual care will become the norm.
10. Primary care should be a major focus in the ACO environment

The report offered some recommendations for providers:

• Focus on vision, goals, metrics and incentives first;
• Embrace risk but focus mainly on resource stewardship;
• Make sure the organization has sound leaderships in place;
• Focus on primary care;
• Embrace the democratization of healthcare; and
• Treat becoming an ACO like a marathon, not a sprint.

For access to the survey, please click here.