Care Transformation Strategies and Approaches of Accountable Care Organizations

Medical Care Research and Review : MCRR
Valerie A LewisGenevra F Murray

Abstract

Although accountable care organizations (ACOs) proliferate, little is known about the activities and strategies ACOs are pursuing to meet goals of reducing costs and improving quality. We use semistructured interviews with executives at 16 ACOs to understand ACO approaches. We identified two overarching ACO approaches to changing clinical care: a practice-based transformation approach, working to overhaul care processes and teams from the inside out; and an overlay approach, where ACO activities were centralized and delivered external to physician practices. We additionally identified four methods ACOs were using to achieve their aims: using patient support roles; targeted clinics, events, programs, and interventions; clinical process standardization; and tracking and identifying patients on which to focus resources. We expect that ACOs using either of the major approaches can succeed under current ACO programs, but that as value-based payment programs mature, ACOs will need to undertake practice-based approaches to be successful in the long term.

References

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Citations

Dec 13, 2017·Medical Care Research and Review : MCRR·Brystana G KaufmanEmily C O'Brien
Aug 15, 2019·Medical Care Research and Review : MCRR·Janette DillChivon Mingo
Aug 28, 2019·Journal of General Internal Medicine·Brystana G KaufmanYing Xian
Oct 3, 2020·Journal of General Internal Medicine·Taressa K FrazeCarrie H Colla
Nov 11, 2019·Journal of General Internal Medicine·Adam A MarkovitzJohn M Hollingsworth
May 1, 2019·Healthcare·Alan LevitonTobias Loddenkemper
Dec 8, 2020·Health Services Research·Dennis P ScanlonCheryl L Damberg
Mar 3, 2021·Joint Commission Journal on Quality and Patient Safety·Stephen M ShortellElina Reponen

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