A Few Notes on the First Year of the ACO

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ACO-thumb1On Friday, we looked at Debra Ness and William Kramer’s more optimistic perspective on the first year of the Pioneer Accountable Care Organizations (ACOs). As they pointed out, the Pioneer ACOs experienced many positive results, including meeting their quality performance metrics, reducing hospital readmission rates, reducing costs, etc.

Yes, nine of the 32 are leaving the program, but Ness and Kramer said this is all to be expected when transforming one of the biggest and most expensive healthcare systems in the world.

Naturally, there are also a few notes to be taken from this first year. Ness and Kramer offer two, one an imperative and the other a plea.

First, the imperative: “We are convinced that ACOs will only succeed over the long term if they genuinely engage patients, families, and consumers, in a comprehensive way, in both their design and their implementation.”

Two things are needed for this comprehensive care to be achieved, they write: first, accountability for high performance on patient-reported outcomes, care experience, and care coordination; second, building healthcare on the firm foundation of primary care.

“Good primary care is essential to the prevention, coordination, and care management that produce better health outcomes, better care experience, more appropriate use of services, and lower costs,” they conclude.

Then, the plea: Stop looking for the magic bullet.

“In this country, we tend to look for magic bullets – perfect and permanent fixes,” they observe. “If a new approach doesn’t work immediately, we sometimes become disillusioned.”

Based on the results outlined in our last post and based on the goals of the ACO model, doesn’t it deserve better, they wonder? Doesn’t it deserve a little more patience?

“The nation has few higher priorities than to create a healthcare system that coordinates patient care, improves outcomes, and ends miserable patient experiences, duplication, waste, errors, and skyrocketing costs that are crippling families, businesses, and government,” they assert. “We think the Pioneer ACOs are on a promising track to realize better care and better value for our healthcare dollars.”

They then add, “If these health systems increasingly become more patient- and family-centric, and strengthen their delivery of primary care, we will make progress.”

As healthcare executives, how patient are you willing to be with the ACO model? Do you foresee a future where it enables your organization, should you choose to join the program, to be more patient-and family-centric? What are you doing to improve the accountability of your organization and to strengthen its primary-care services?

-by Pete Fernbaugh

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