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Creating Successful ACOs

Now, more than ever before, in a healthcare climate that encourages coordinated care and value-based care, healthcare providers need to be strategic in finding out the different ways that their available resources can help them to care for their patients. In the case of Accountable Care Organizations (ACOs), these healthcare provider groups are in a unique and favorable position to optimize the quality of care and reduce costs. ACOs are formed for the purpose of gathering healthcare providers into a group network that will work together to achieve and share in the cost-savings while maintaining or elevating quality care.

Here are a few more tips for creating successful ACOs.

Leveraging the EHR to facilitate data exchange

ACOs are already in a good position to provide quality care by coordinating the efforts of various healthcare service providers into a single network that is accessible to the patient. However, the record of services and management of patient data need to be highly organized and communicable among the different sectors of the ACO. Having an EHR that accurately collects detailed patient information provides a good foundation from which to build upon a patient’s health. However, it’s not enough for individual providers (e.g. primary care physicians, specialists) to use their EHR successfully if they cannot communicate and integrate their medical decisions and actions with each other. Ideal ACOs require EHR interoperability, so that the transfer and communication of data from one provider to another or from one level of care to another within an ACO is continuous. ACOs, like MultiCare Connected Care in Washington state, focus on health information exchange to coordinate effective care that can achieve or surpass quality measures.

Teamwork at every level of care

The foundation of an ACO is obviously team-based care, using the skills and resources from the varying levels of patient care (primary care physicians, hospitals, specialists). A success story can be seen in Coastal Medical, an ACO based in Massachusetts that reduced costs and met quality metrics, leading to 7.2 million dollars in savings. What was its recipe for success? Preventative measures to keep patients out of the ER, such as year-round availability, longer working hours during the weekday, and incorporating nurse care managers to help patients transition safely and properly to home care or rehabilitation after hospital discharge.

Adding medical scribes to the team of trained healthcare staff can also facilitate quality care and smooth the transition from acute to post-acute care through their accurate EHR documentation that builds the bridge between the medical actions of one healthcare provider to another.

Other optimisation strategies

Paying attention to the size of an ACO can also guide successful management. For example, larger ACOs, contracting with multiple commercial payers, may have multiple and varying quality measures to deal with, according to each contract. Keeping the size of an ACO may seem to make things easier, also in terms of coordinating actions among the various ACO members, however, expanding the size of an ACO could, if made efficient, enhance performing power and leverage negotiations with commercial payers.