The benefits of accountable care organizations can be contentious. They seem to save money, but for whom and when can be nebulous. However, an easily customizable ACO participation strategy and a commitment to social engagement may guarantee repeated success in the ACO space, according to Michael Schatzlein, MD, president and CEO of St. Thomas Health, and Jason Dinger, PhD, CEO of MissionPoint Health Partners, in their talk on the matter at Becker's Hospital Review's 5th Annual Conference in Chicago on May 15.
The two organizations have created a system that caters to its delivery population, while simultaneously engaging providers in the ACO at any level at which they're comfortable.
"Mission Point as an ACO is dealing with a diverse, fragmented market, and there wasn't one product that met the needs of everyone. Our goal was initially to engage with employers and offer a menu of possible forms of support, from flu shots to comprehensive managed network running on shared savings," said Dr. Schatzlein.
The partnership has been so popular that the ACO is going national. "Ascension Health is taking Mission Point national as one of few ACOs that will get money back on shared savings," he added.
According to Dr. Dinger, while the initial impulse for the organization was to go with an already defined plan, the pair decided to think about what the market was demanding – then provide it.
First, alignment among physicians, especially those for whom reimbursement tends to be episodic, was key. Providers can sign up for treating different populations of patients, according to their willingness and ability to handle said patients. Savings are distributed based on the number of patients given care.
Second, health partners – or care navigators – provide care in traditional, ambulatory and integrative care settings. These health partners have illuminated the potential pitfalls ACOs may face that are not health related.
"Number one is that we totally underestimate the number of behavioral health issues out there. Number two, non-clinical issues get in the way. Patients know what they have to do for their health, but it's hard. Inside a successful ACO, they're doing this work – engaging patients on this level so they can hear things they wouldn't during a telephone call – and address them," said Mr. Dinger.
To truly succeed as an ACO, the pair emphasized segmentation of the patient population, addressing the needs of the high-risk population, which usually uses most of the care in a system. "Health systems who have the vision to do this work will see better alignment, market share shifts and brand evolution," said Mr. Dinger.
"If you're not part of an integrated delivery system, you're not part of the future," added Mr. Schatzlein.