Accountable care organizations, in an effort to provide better care at lower costs, provide a number of tools for physicians who participate in those programs. But when asked about the efficacy of those tools in a recent Health Affairs survey, most physicians were lukewarm on the subject, indicating that their own tools and methods could just as easily be used to aid in the transition from volume to value.
Of the tools and resources provided by ACOs -- performance feedback reports, care managers, and data analytics that identify high-risk patients, among others -- relatively few physicians said these resources improved care "a lot," although a slightly greater percentage said they improved care "somewhat." Very few physicians said these tools reduced costs significantly.
Across the three models, care management support was generally viewed as having a larger impact on quality and cost than either performance feedback or information on clinical guidelines.
While those findings held true across all three of the main ACO models, those in Advanced Payment Model ACOs had more favorable views of the model overall. The authors said the makeup of physicians in those models may have been an influence in this finding; physicians in Advanced Model ACOs tended to be primary care physicians as opposed to specialists, and they were more likely to work in small practices and rural areas, predominantly in the South.
Another possible contributor to the discrepancy, the authors said, is the nature of Alternative Payment ACOs themselves, which have less experience with health transformation efforts than the other two models. The latter likely benefited from previous experience with structural support elements such as care management or health IT systems.
When it came to more overarching goals, only a modest number of physicians said ACOs have made successful progress toward achieving those goals. Despite this, one-half to two thirds said participation in an ACO impacted how they care for all of their patients, whether aligned with the ACO or not.
The results suggest that, simply put, physicians and ACOs aren't always on the same page. Many of them feel comfortable in their own ability to make the leap from volume to value.