Only 30 percent of the 480 Medicare Shared Savings Program Accountable Care Organizations (ACOs) earned shared savings in a meaningful amount in 2015, a percentage that only rose to 56% in 2016.
Yes, it is a complex endeavor. But given 16 of the quality performance standards for ACOs are tied to medication adherence, the role of the pharmacy in care management there is a clear pathway to improving chronic care and unlocking Medicare Shared Savings through medication management.
Step 1: Ask the right questions and pick the right model
Our best insight on how to set yourself up for success is two-fold. You must begin by conducting the necessary initial analysis of your patient population and the identification of areas where you will likely be able to make measurable, meaningful impacts on quality. Secondarily, the ACO must be willing to engage mission-driven clinics, practices and partners committed to a culture of care focused on achieving the “Triple Aim.” Read more
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Step 2: Build the right team
What are the qualities of team members throughout the accountable care organizations networks, especially including the clinical staff, that increase the likelihood for success? Who is on the team and what role are they playing? What kind of organizations make the best partners?
“Active collaboration between the ACO and partner clinics to discuss, understand and agree upon program expectations is key to building a successful program. Perhaps more important is making sure that your program starts by engaging the right people at the right clinic sites at the right time.” Read more
Step 3: Define growth and pick the right partners
“Whether ACO success is ultimately measured in improved care delivery and/or significant financial savings, it is not uncommon for ACOs to lack the entirety of capabilities in-house needed to design and implement a successful program. Following an exhaustive internal skills and service gap evaluation, Louisiana Physicians Accountable Care Organization (LPACO) identified a patient population that could benefit from externally provided medication management services in underserved, rural areas.
The key to building successful partnerships under the ACO model lies in clearly defining and agreeing to the requisite steps for a fully integrated partnership across the ACO. These steps must be organized in manageable increments, have clearly defined owners and partnership value delivery checkpoints. Read more
Step 4: Learn from ACOs using this pathway successfully
“From an individual physician’s perspective, a successful ACO engagement should provide access to new technologies, generate mentors and a new network of colleagues from which everyone can learn. It should also generate mutually beneficial partnerships, including ones with care coordination and medication management providers, solutions to practice management issues. Ultimately it should generate income from value-based care delivery.
“From an ACO leadership perspective, success means creating revenue opportunities for partners, helping them get their population health work right, improving their quality measures and closing gaps in care. The organization as a whole should provide “wins” for the practices and predictably generate income, not be a driver of additional cost.” – Dr. Joshua Lowentritt, practicing Internist and Founder/Chair, Louisiana Physicians Accountable Care Organization. Read more
Curant Health has been leading the transition to value-based care for our provider partners for more than a decade. Through partners like Universal American, Louisiana Physicians ACO and others, we fill gaps in care coordination and help improve medication adherence for patients with chronic illness to improve key quality metrics and patient outcomes. Our commitment to improving outcomes, improving lives and reducing the overall healthcare spend through medication management and care coordination is the cornerstone of our longevity and our future.
If you are an ACO ‘parent company’ leader, a physician leading an ACO affiliated practice or the practice’s ACO ‘champion,’ we want to talk to you about what’s working well and where are the gaps that need filling in your quest to improve quality metrics and unlock shared savings.
Contact Kaitlyn Roberts, firstname.lastname@example.org
, Health Systems Specialist.