The ACO’s Role in Providing a Superior Patient Experience

5 Key Takeaways:

1. Accountability. ACOs are, by definition, held accountable for the quality and cost of care they provide. That means they must prioritize serving their highest-risk patients – patients that may have multiple chronic conditions and who, generally, cost the system the most. As an ACO, it’s not sufficient to simply serve any patient who comes through the door. ACOs have to understand the entire patient, including medical and social needs, in order to help connect them to needed services and improve their health over time.
2. Quality metrics. One of the key challenges facing ACOs is the variety of quality metrics, goals, and thresholds they are required to keep track of or meet. Even when different payers require reporting on overlapping quality measures, when the goals or thresholds differ, developing cohesive internal campaigns can be difficult. Streamlining communication to providers around these metrics is essential.
3. Outcomes. ACO quality metrics have evolved over time. No longer are they process-oriented, or focused on things like checking A1C levels or completing annual wellness visits. Instead, ACOs are more and more accountable for actual outcomes, such as blood pressure level. This evolution has presented new challenges for ACOs who must develop relationships with patients in order to ensure their success.
4. Access to care. Patients of all ages and backgrounds face a variety of barriers to care – factors that prevent or delay them from seeking needed healthcare services. Understanding what is getting in the way of patients seeking care, from the ease-of-use of digital tools to unmet social needs like housing, is a critical first step to improving access to care. And access enables a better patient-provider relationship, foundational to a positive patient experience.
5. Social needs. Housing insecurity and food insecurity are just two examples of social needs that have a huge impact on a person’s health outcomes. In order to make advances in health outcomes and provide a superior patient experience, ACOs have to screen patients for social needs and address those needs. This requires working with community partners that can connect patients to social assistance and following up with those partners to close the loop.