Accountable care organizations need to do better at engaging patients, report finds

Strengthening patient engagement is key to improving the impact of accountable care organizations (ACOs), according to a new resource guide compiled by the Health Care Transformation Task Force (HCTTF) and the National Association of ACOs (NAACOS).

ACOs differ from traditional fee-for-service (FFS) systems in that they focus on keeping patients healthy and out of the hospital by prioritizing care coordination and preventative care. This theoretically leads to improved outcomes and a better patient experience, said the two organizations.

The Medicare Shared Savings Program (MSSP) – the largest ACO initiative in the United States – has more than a decade of experience in pursuing these goals. The Centers for Medicare and Medicaid Services (CMS) has also tested several accountable care models through the CMS Innovation Center, including the current ACO Realizing Equity, Access, and Community Health (REACH) Model. 

However, patients and their caregivers are often unaware of how their care is being coordinated or the other benefits value-based care models provide. Thus ACOs should implement engagement strategies aimed at reducing confusion and helping patients understand the ACO model, the guide said. 

“Alternative payment models aim to improve beneficiary outcomes by paying for care differently and giving providers tools to redesign care. To achieve this aim, patients must be at the center of all aspects of the payment model,” the report said. “Unfortunately, in recent years discussion on the success of APMs has overly focused on cost savings. To recenter beneficiaries in the conversation on APMs, NAACOS and HCTTF took this step to identify opportunities to improve patient engagement and person-centered approaches in ACOs, the largest and longest running APM.”

Read more: Benefits advisor’s guide to value-based primary care: the antidote for rising health care costs

Recommendations include:

• Tailoring beneficiary communications to different patient populations. Current regulations require a one-size-fits-all approach which limits educational and engagement potential to specific audiences. For example, beneficiaries are best served when communicated with in their primary language to build trust and foster the full understanding of what is being communicated to them, said the report. 
• Applying waivers consistently across various ACO models. ACOs waive certain Medicare FFS requirements such as cost-sharing for certain services or reducing minimum nights of a hospital stay before discharging to a skilled nursing facility. Currently, waivers are applied inconsistently across ACOs.
• Gathering meaningful input from patients, family caregivers and communities. Effective two-way communication promotes person-centeredness and can advance population health goals, said the report.