Because models for accountable care organizations (ACOs) are so new, it’s difficult to predict if they will develop along the lines evident today, or morph into something else. But most agree that some type of risk-based arrangement will survive.
During a recent Covisint Healthcare webinar, three healthcare executives shared four success factors that can propel shared savings and ACOs, as well as the four pitfalls that can sink them, even as these value-based models are still in their infancy. However, no set recipe exists for these new payment and care delivery models.
Craig Behm, executive director of MedChi Network Services, a subsidiary of the Maryland State Medical Society that offers management services to physicians; Joseph Pollman, executive director of knowledge management at Community Health Network; and John Haughton, MD, Covisint chief medical information officer, agreed that a major point of debate concerns whether to build ACO infrastructure first or pursue provider contracts for shared savings.
[See also: Accountable Care Organizations explained.]
But while infrastructure is critical as to why some ACOs are successful and others are not, many of the other factors determining success or failure are not technical but found within participating physicians and the culture of their organizations.
4 factors driving ACOs failure:
- Doing too much too soon, which may show up in “plumbing” problems—the IT systems and data exchange;
- Doing too little—not watching their transitions of care;
- Not enough physician and staff buy-in;
- Have not yet developed aligned incentives, which require different cultural values, such as team-based care instead of physicians performing in silos.
4 factors for ACO success:
- Immediately pay back shared savings;
- Require standardization of processes and data, and transparency so measures, incentives and penalties are clear;
- Have strong physician engagement;
- Offer a better understanding of the program, risk of the patient at the population level and where variances exist.