The Health Care Transformation Task Force (HCTTF) recently released a comprehensive analysis of high-performing accountable care organizations (ACO) as a way to shine a light on the programs.
“Levers of Successful ACOs” includes interviews with leaders involved in 11 highly successful ACOs to assess the structures and strategies that led to success.
HCTTF views the report as a “tactical playbook for understanding, prioritizing and implementing successful ACOs.”
As healthcare leaders look for ways to create value-based payment models, many organizations are implementing ACOs. HCTTF said there are more than 900 ACOs that cover about 32.4 million lives in the U.S.
The report highlights ACOs’ experience by evaluating proficiency across key activities, educating organizations about the importance of key activities and prioritizing improvement efforts based on unique needs.
“ACOs have demonstrated great promise at improving care and reducing costs, as evidenced by the latest results from Medicare ACOs,” said HCTTF Executive Director Jeff Micklos. “The task force is committed to the spread of alternative payment models and sharing learnings from model participants. This study includes replicable strategies especially beneficial for smaller, independent organizations without the capital to invest in custom, hands-on support.”
Travis Broome, vice president for policy at Aledade, Inc., and co-chair of the task force’s accountable care work group, said ACOs have several years of experience. ACOs have learned what works and what doesn't. “While approaches to ACO implementation vary, this study covers the core attributes of success for others to emulate,” Broome said.
The study comes on the heels of a recent report in Health Affairs that highlighted lessons learned from ACOs across the globe. The Health Affairs report said ACOs present “new opportunities to develop the evidence necessary to implement, scale and sustain these needed innovations in healthcare delivery.” ACO results in the U.S. “demonstrate quality improvements with some overall modest reductions in health system costs,” according to the report. That report also created a framework for accessing ACOs and offered lessons learned outside of the U.S., including from Germany, Nepal and the Netherlands.
Closer to home, the CMS recently found that 11 of 18 Next Generation Accountable Care Organizations (ACOs) earned savings in 2016. Overall, ACOs cut gross Medicare spending by $836 million last year, including $70.6 million in net savings returned to the Medicare Trust Fund.
While President Barack Obama's administration would have shouted those results from the rooftops, President Donald Trump'saAdministration has been quiet about the successes of ACOs. The reason could be the Trump administration’s apparent lukewarm support of these types of programs. The CMS recently canceled or rolled back a number of bundled payment models and is looking into a "new direction" for its innovation center.
CMS Administrator Seema Verma recently said the agency is revising current quality measures across all quality payment programs. The CMS also wants to cut regulatory burdens for providers. “Our vision is to develop models that promote a patient-centered system of care within a market-driven healthcare system. Models should empower consumers to make decisions that are right for them and providers should compete around value and quality,” she said.
Despite the administration’s stance, healthcare organizations are moving ahead with ACOs. That includes 17 states that have adopted or are considering creating ACOs to manage cost and deliver better care, according to a state report by Change Healthcare.
The first quarter of 2017 saw ACOs grow by 11%. Beyond ACOs, many healthcare companies are moving into other alternative payment models (APM). A recent Health Care Payment Learning & Action Network (LAN) report revealed that 29% of U.S. healthcare payments were connected to APMs in 2016. That was six percentage points better than the previous year. LAN, a public-private partnership created by HHS, hopes the percentage will reach 50% by next year.