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Transitioning to an ACO Model: Five Factors to Consider

Accountable Care Solutions

Value-based care models can take many different forms, so every path to prepare for this transition is unique. Some of our customers are moving into full-fledged accountable care organizations (ACOs) quickly. Others are “testing the waters” with hybrid models and pilot programs. Before taking a bold step toward accountable care, consider the following success factors:

  1. Leadership and internal culture. The transition to an accountable care model begins with a leadership team that shares the vision and is willing to invest in it. Leaders must spearhead change management efforts and effective internal communications. Driving quality improvement, innovation and engagement will require input from all staff, both clinical and non-clinical. If your culture already promotes collaboration and is open to new ideas, these changes will be easier to accomplish.

  2. Technology and infrastructure. Actionable patient data will be the driving force of improved quality and efficiency. This patient data must be targeted and shared across the care continuum to support collaboration and decision-making, and to prevent missed steps and miscommunication. Specialized technology can also offer real-time insight that can be used to create dynamic care plans and reach patients with targeted information and resources through mobile or Web-based tools.

  3. Level of clinical integration. Clinically integrated networks (CINs) are a strong foundation for ACOs. CINs can easily promote shared protocols, efficiency goals, education and training. This model is a good starting point for practices that are not ready to transition to a full accountable care organization.

  4. Population health management expertise. ACOs must be able to stratify patients by risk. Based on this data, your organization can develop strategies to manage those with costly health conditions. Once patient data is matched with the latest clinical standards, providers and payers can collaborate to find new ways to improve outcomes for specific populations. An initial analysis of population health will also provide a good baseline as you track and measure progress in meeting quality and cost-reduction goals.

  5. Member growth potential. Member growth will be an important strategy to offset reduced utilization of high-cost services. Practices in a highly competitive area will likely be motivated to take on risk in hopes of greater rewards. Organizations that can readily attract and retain patients will have a distinct advantage.

Whether you’re creating a full ACO, a pilot program or simply applying value-based care model concepts and technology to improve care, outcomes, value and the patient experience, you’ll be wise to consider these factors prior to launch. By preparing to face these challenges now, your organization can position itself for a sustainable future.