The keys to ACO success

Premier Research Institute Vice President and Chief Scientist Eugene A. Kroch and two hospital executives shared what they believe to be the top characteristics associated with a healthcare organization’s readiness to form an accountable care organization (ACO) during a webinar on Thursday.

According to Kroch, as a way to enhance the understanding of what it takes to become an effective ACO, Premier defined the requirements for a model ACO, and based on the model requirements, developed a capabilities framework tool designed to assess an organization’s progress toward meeting those ACO requirements. The requirement model included six core components: a patient-centered foundation, a health home, a high-value network, payer partnership, population health data management, and ACO leadership.

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Kroch said Premier then created the Partnership for Care Transformation (PACT) collaborative that involved 59 hospital-based organizations and their transition to accountable care. Premier assessed the organizations on 42 capabilities, divided further into 154 specific operating activities, and shared the results in a recently-released Commonwealth Fund report, which was discussed during Thursday’s webinar.

Overall, Kroch said the national state of readiness for accountable care among hospitals was modest. He did find, however, that several characteristics among hospitals appeared to be associated with greater readiness to form an ACO, including a strong patient-centered focus, full or partial ownership of a health plan, clinical integration across the continuum of care, and positive relationships with primary care and specialty care providers in the market, among others.

“We found that out of the 59 organizations we assessed, there was variation among the organizations that had a higher readiness score – they didn’t always score well on the same of the six core components,” he said. “Scoring well in one component does not always translate to readiness in all components.”

During the webinar, Patrick Falvey, Ph.D., senior vice president and chief integration officer at Aurora Health Care, a nonprofit integrated healthcare provider in Wisconsin and Illinois and high-scoring organization in Premier’s assessment, shared how strong relationships with primary and specialty care physicians, strong organizational relationships (with ACO governance, a medical group leadership council, and a payer-provider role definition), along with population health analytics and sophisticated EHRs, were key factors in transitioning to accountable care.

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“We focus on making sure everyone at our organization is always on the same page,” said Falvey.

Steven Blumberg, senior vice president and executive director at AtlantiCare Health Solutions in New Jersey, another high-scoring organization in Premier’s assessment, said during the webinar that part of his organization’s transition to accountable care process was putting a strong focus on addressing population management infrastructure, particularly chronic disease management.

Blumberg mentioned AtlantiCare’s creation of the Special Care Center (SCC), a patient-centered medical home for high-risk populations with multiple chronic conditions.

“The SCC model includes multiple features to help reduce outcome disparities by having culturally and linguistically matched physicians and health coaches, in-depth and culturally appropriate educational materials, improved access, and team training on cultural competency,” he said.

Blumberg added that the SCC model also helps patients switch to alternative lower-cost medications, reduces unnecessary tests and uses lower cost care settings when needed, and better manages patients to keep them out of the hospital.

Kroch added that overall, any healthcare organization moving towards accountable care will need to focus on managing populations, physician and executive leadership, and a strong primary care foundation in order to be successful.
 

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