Enhancing Patient Engagement in Accountable Care Organizations: Key Strategies and Trends
A recent report by the Health Care Transformation Task Force (HCTTF) and the National Association of ACOs (NAACOS) emphasizes the importance of improving patient engagement for the success of Accountable Care Organizations (ACOs). The report outlines several strategies to achieve this, including enhancing communication, redesigning benefit structures, and increasing patient input in governance. Effective patient engagement is seen as a cornerstone for ACOs, which aim to improve healthcare quality, reduce costs, and enhance care coordination.
ACOs, as alternative payment models (APMs), focus on primary and preventive care, addressing social determinants of health, and reducing racial and ethnic disparities in healthcare. Despite their benefits, many patients are unaware of their participation in ACOs and how these organizations can positively impact their healthcare experience. This lack of awareness is attributed to restrictive communication policies, which have only recently been relaxed by the Centers for Medicare & Medicaid Services (CMS).
The report suggests that personalized communication, rather than bureaucratic messaging, would be more effective in engaging patients. Aligning communication policies with those governing Medicare Advantage and granting ACOs more flexibility in beneficiary engagement could further enhance patient understanding and involvement.
Physician participation in ACOs and medical homes has grown steadily since 2014, according to an AMA survey. In 2022, 57.8% of physicians reported belonging to an ACO, up from 44% in 2016. Despite this growth, fee-for-service (FFS) remains the predominant payment method, with 86.4% of physicians reporting FFS revenue in 2022. Alternative payment methods, such as pay-for-performance and bundled payments, have not seen significant growth, indicating a continued reliance on FFS models.
Community-based organizations (CBOs) are identified as valuable partners for ACOs, helping to improve patient experiences, quality outcomes, and cost efficiency. ACOs aim to provide coordinated, high-quality care while managing healthcare costs for Medicare beneficiaries. CMS has set a goal for more than 50% of Medicare beneficiaries to be part of an accountable care relationship by 2030, highlighting the importance of ACOs in the evolving healthcare landscape.
The ACO model includes various practitioners and emphasizes care coordination, evidence-based medicine, patient engagement, and addressing social determinants of health. ACOs operate under different tracks, with varying levels of financial risk and reward, to encourage broader participation and gradual transition to risk-based models.
CMS's recent proposals aim to increase ACO participation, especially in rural and underserved areas, by providing advance payments and promoting health equity. The introduction of the ACO REACH Model in January 2023 underscores CMS's commitment to addressing health disparities and supporting patient-centered care.
In summary, enhancing patient engagement, expanding ACO participation, and fostering partnerships with CBOs are critical for the success and growth of ACOs. These efforts are essential for achieving better patient outcomes, reducing healthcare costs, and advancing the value-based care model.
References:
Nearly 60% of doctors work in a practice that’s part of an ACO | American Medical Association
How Evidence-Based Program Providers and Accountable Care Organizations Can Work Together on Quality and Performance Improvement
How ACO models can improve to support patient engagement | TechTarget