A recent evaluation of high-performing ACOs conducted by the Health Care Transformation Task Force (HCTTF) sought differentiating characteristics in common among the ACOs.a HCTTF reviewed a sample of 21 ACOs, each having at least one contract with the Medicare Shared Savings Program, one commercial contract and a diverse geographic service area. A recent HCTTF blog post notes shared saving rates among the most successful ACOs of greater than 2% and quality score above 90.b The HCTTF found all 21 high-performing ACOs had five characteristics in common:
- Participated in the program at least two years and experienced improved performance over time
- Experienced prior risk-based contracting and were able to spread risk across several value-based payment arrangements, helping to finance necessary investments in innovative care delivery
- Built a high-value innovative culture with effective patient outreach and engagement
- Configured groups of effective population health programs, such as care management, post-acute care networks, behavioral health screening, substance abuse and e-screenings
- Invested in enough infrastructure to ensure continuous performance improvement over time, including investment in both total-cost-of-care and condition-specific-episode analytics
- High-performing ACOs also all agreed “organizations need to spend to save” based on the realization that shared savings, even if achieved, would not be paid out for at least two years, the HCTTF found.
See related article: Assembling the essentials for successful population health management
a. HCTTF, Levers of Successful ACOs: Insights from The Health Care Transformation Task Force, Nov. 8, 2017.
b. Pierce-Wrobel, C., and Micklos, J., “How the Most Successful ACOs Act as Factories of Innovation,” Health Affairs Blog, Jan. 29, 2018.