3 Strategies Driving ACO Success
Many have said, "If you've seen one accountable care organization — then you've seen one accountable care organization." There is no one set recipe for ACO success, so the ACOs that are spread throughout the country have a variety of programs in place, though they are all striving to achieve the triple aim of improved care quality and patient experience while lowering costs.
The following are three different programs or initiatives gleaned from three ACOs that they say have contributed greatly to their successes in accountable care.
1. Partnering with a post-acute care providers. Many of the acute-care hospitals, health systems and physician groups that formed ACOs did not originally have post-acute care included in their care continuums. However, coordinating patients' post-acute care can result in major cost savings and care quality improvement for ACOs.
Atrius Health in Newton, Mass., a Medicare Pioneer ACO, expanded its care continuum into the post-acute arena care by integrating VNA Care Network and Hospice as an affiliate. "Our work with our home health partner to better coordinate care is showing lots of fruits," Emily Brower, executive director of accountable care programs for Atrius Health, says.
In addition to directly integrating VNA Care Network and Hospice into the network, Atrius Health has created a coverage plan for its clinicians to see ACO patients when they are admitted to select skilled nursing facilities in Atrius Health's coverage area. That way, the patient receives a care plan from his or her ACO care providers, allowing the ACO to better manage and coordinate care for patients.
2. Using care coordinators. Care coordination is one of the main tenets of accountable care, since it helps cut redundancies in care, thus lowering costs. Many ACOs have made care coordinators available to patients. Cincinnati-based Mercy Health's Medicare Shared Savings ACO, Mercy Health Select, has had great success with its care coordination program, according to Amy Frankowski, MD, senior medical director of Mercy Health Select.
Nurses in Mercy Health Select work as care coordinators for high-risk patients. Through the program, patients have direct access to their care coordinators, via cell phone, in case they need a health issue addressed at any time. Also, the ACO's care coordinators can consult and work with behavioral health specialists, dieticians and pharmacists when necessary. "If there are things the patient needs that the [care coordinator] doesn't have in-depth skills in, the coordinator can reach out to a bigger team to help with the patient," Dr. Frankowski says.
3. Providing care transition support. Patients are often vulnerable when transitioning from an inpatient setting to an outpatient, skilled nurse facility or home care. To reduce readmission rates, many ACOs have a care transition program, guiding patients between care settings smoothly. John C. Lincoln ACO in Phoenix, a Medicare Shared Savings ACO, has a care transition program that has been extremely successful.
JCL ACO employs military medic veterans as care transition specialists. The transition specialists work with ACO patients with chronic illnesses such as COPD, pneumonia, chronic heart failure and acute myocardial infarction, according to Nathan Anspach, CEO of the ACO. The specialists work with the patients in the hospital and in their homes, addressing both clinical and social health issues. The program has helped lower readmission rates at John C. Lincoln to 6 percent.
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