Study finds ACOs still focused on early stages of care redesign

ACOs are gearing up to take on more financial risk, but most still lag in their ability to manage population health, according to a survey of ACOs published in Health Affairs

The survey, conducted by Leavitt Partners and the National Association of ACOs from January to April, polled about one-quarter of the nation's ACOs, including Medicare, Medicaid and commercial contracts. 

The survey authors found most ACOs (90 percent) had at least one upside-only shared savings contract, and only about half had a contract with downside risk. However, most ACOs had plans to take on downside risk soon — 47 percent indicated plans for shared savings contracts and 38 percent had plans for capitation. 

Despite increased interest in taking on financial risk, most ACOs were still in the early stages of care redesign, according to the survey authors. Almost all (95 percent) had care coordinators, and many were involved in activities associated with the early stages of population health management, such as readmission reduction, emergency department reduction and chronic care management. However, few ACOs were engaged in what the authors called "more aggressive care delivery changes," such as the integration of behavioral health services and medication management. 

"While ACOs are continuing to grow and there are strong pressures to push provider-born risk, this risk cannot be pushed faster than ACOs' ability to manage it," the survey authors wrote in Health Affairs. "Our results indicate that ACOs have both the appetite and the plans to take on more risk; however, ACOs need time and the support of their payer partners to make that transition."

More articles on ACOs:

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3 ways to expand value-based care

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