ACOs are seeking new ways to expand population health management capabilities, particularly as they mature beyond initial challenges associated with financial pressures and payer requirements, according to a recent study from Premier and the Robert Wood Johnson Foundation.
Collecting information from surveys, interviews and Medicare claims data, researchers aimed to determine what works in ACOs, what doesn't and opportunities to improve. The study involved 19 ACOs in Premier's Population Health Management Collaborative, most of which participate in the Medicare Shared Savings Program and a commercial program.
The primary takeaway from this research was ACO leaders have a strong interest in expanding their relationships with social service agencies and other community-based organizations. Nearly every ACO studied reported already working with social service organizations, but 84 percent said they could use increased support from those community partners. Many saw it as an opportunity to carve out a niche outside of traditional, hospital-based work.
"Increasingly, providers understand how important the things that happen outside of the doctor's office or hospital are to improving and managing a person's health," Andrea Ducas, program officer at RWJF, said in a statement. "To that end, some leading ACOs are expanding their services to include more upstream, preventive support for patients and are also expanding their work to reach entire communities, rather than just focusing on their assigned beneficiaries."
While all the ACOs cited these concerns, the report notes that some ACOs, the later adopters in particular, are still focusing on financial pressures and requirements associated with managing specific populations. More advanced ACOs with more experience under their belt have been able to broaden their focus and think about the need to bring in external services to improve population health, according to the report.
However, the researchers found a number of barriers still exist for ACOs to truly promote broader population health initiatives. These include inadequate funding, data interoperability challenges, shifting the physician mindset from fee-for-service to fee-for-value, payer pressures and lack of understanding of the return on investment for population health services.
The report published Thursday is the first of two parts. The second portion compares patient outcomes and care costs and will be published separately, according to a statement from Premier.
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