4 Factors of a Truly Transformational ACO

Many health systems and hospitals across the country are moving quickly to become accountable care organizations. However, not all ACOs are poised to achieve the triple aim of improved outcomes, higher quality of care and lower healthcare costs.

Rick Weil, PhD, a partner and member of Oliver Wyman's health and life sciences practice, recently co-authored a study titled "The ACO Surprise," which outlines just how fast the new care delivery model is catching on.

As part of the study, Mr. Weil outlines four factors that set ACOs ahead of their competition. Focusing on these four aspects will allow ACOs to make greater strides toward the triple aim and be more successful in their market.

1. Prioritize clinical transformation. After setting up the actual organization and signing the contracts to become an ACO, leaders need to begin focusing on implementing the changes they talked about during the beginning of the process, and clinical transformation is the most important of those changes.

"If you're a health system, you need to enable those changes and get the right physician leaders who will drive those changes," says Mr. Weil. "That will drive value creation in the population health management world."

Clinical transformation needs to visibly be on the CEO's agenda, not just discussed vaguely as a strategic initiative. As part of this effort, the organization should also be investing a lot in infrastructure.

2. Focus on accountable care, not the organizational structure. While the organizational structure is an important part of the ACO equation, to truly be transformative, leaders need to make accountability a priority across the organization. "Don't focus all of your energy on getting organized," says Mr. Weil. "You need to focus on accountability for the care."

A big part of that is identifying over- and under-utilization and eliminating both of them in the organization to have it run more efficiently. Care providers should also be encouraged to think in a team mindset as opposed to just about themselves as individuals. "That's what accountability for care is: shifting to patient- and team-oriented care as opposed to individual practitioners," he says.

3. Put patients at the center. This aspect may seem like an obvious aspect of an ACO, but few organizations are making the changes necessary to truly put patients at the center of the care model. Providers should cease to think only about body-part medicine and instead start thinking about the patients' overall health, which means both their clinical and social needs.

According to Mr. Weil, organizations that have patients at the center change their schedules to make care providers available during off-hours, and the care providers will involve patients more in their care decisions. "Those are not pervasive in today's practices," he says.

4. Engage care providers in a new way. Part of putting patients at the center means getting the physicians involved in the ACO to commit to the patient-centric model of care. "When you go into a doctors' office or an operating room, it's very much a physician-centric model," says Mr. Weil. That needs to change in order to achieve  success as an ACO.

"You need to make more direct connections between [physicians] and the triple aim," Mr. Weil says. That should involve compensating physicians differently in order to incentivize them to focus on quality of care, not the volume of patients they see. Mr. Weil also recommends putting physicians in charge of subsets of the population to look at the total cost of care there.

In addition to focusing on these four aspects of ACOs, organizations should be sure to do one more thing: move quickly. "If you don't move fast enough, someone else in your market will," says Mr. Weil. And that could mean losing out on market share and profits down the line.

More Articles on ACOs:

ACO Growth Patterns
6 Early ACO Mistakes to Avoid
Survey: 1% of Healthcare Communicators Feel Prepared to Explain ACOs to Patients

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