Analysis: 6 strategies of successful ACOs revealed in OIG study

•  A study highlighting six common practices of successful ACOs was released last week by the Office of the Inspector General (OIG). 
• The report could be described as a high-level roadmap to success in any population health-based arrangement.

Last week, the U.S. Department of Health and Human Services Office of the Inspector General (OIG) released a study, “ACOs’ Strategies for Transitioning to Value-Based Care: Lessons from the Medicare Shared Savings Program,” which highlights six common practices of successful ACOs.

The study finds that successful ACOs all employ the following practices:

1. Deploy multiple sophisticated physician- and beneficiary-engagement strategies.
2. Risk stratify their populations and have dedicated resources for managing costly/complex beneficiaries.
3. Increase primary care access via several channels to reduce unnecessary hospitalizations and deploy hospitalists.
4. Manage PAC spend by partnering with select network of PAC providers.
5. Integrate resources to address behavioral health and social needs into the ACO network.
6.  Deploy a variety of IT strategies to increase information sharing among providers.  

Takeaway

Roadmap to success: While the OIG report doesn’t go to great depth, it could be described as a high-level roadmap to success in any population health-based arrangement.

Why annual wellness visits are so important: The report calls out the use of the Medicare Annual Wellness visit as a strategy to both engage beneficiaries and identify and address gaps in care. Beyond engaging the beneficiary, the AWV also:

• Helps secure a beneficiary’s attribution to the ACO (given the relatively high payment rate on the case).
• Provides an opportunity to annually capture existing chronic disease diagnosis codes that factor into the HCC score calculation.
• Improves performance on quality measures like immunizations and cancer, depression and tobacco-use screenings by closing care gaps.

All of these are good things if you want to succeed at financially managing populations and develop relationships with your patients.

The report’s other findings related the use of select networks of PAC providers mirror the results we’ve seen in other CMS value-based programs like Bundled Payments for Care Improvement and Comprehensive Care for Joint Replacement.

HFMA’s original series on successful high-value PAC networks: HFMA has a two-part series profiling the strategies used by organizations that have successfully developed high-value PAC networks:

• Hfm magazine July issue: “Why PAC discharge choices are key to success under risk-based payments”
• Hfm August issue: “3 essentials for creating and managing a high-value PAC network”