Accountable Care Organizations (ACOs) Can Boost Savings

Accountable care organizations (ACOs) are voluntary collaborations of practitioners, medical facilities, and other healthcare providers to provide coordinated, high-quality care to Medicare beneficiaries. The primary objective is to ensure that patients receive the right treatment at the right moment while preventing unnecessary duplication of medical services and overcoming clinical errors.

When an ACO is efficient and effective in providing adequate care and strategically spending healthcare finances, the ACO will receive a certain amount of the savings it gained for the Medicare Shared Savings Program (MSSP). Established by the Affordable Care Act, MSSP is dedicated to improving individual health, population health, and reducing expenditure growth.

According to the Centers for Medicare & Medicaid Services (CMS), ACOs participating in the MSSP netted nearly $2.3 billion in performance payments (shared savings) in 2020 while saving Medicare $1.9 billion. This represents the fourth year of savings for Medicare.

ACOs Practices Boosting Savings:

ACOs strive to eliminate fragmentation in clinical outcomes and expenditures by providing clinicians with incentives and methodologies to offer high-quality, coordinated care that effectively enhances outcomes for individuals. So far, over 12.1 million Medicare fee-for-service enrollees are served by a primary care physician participating in Medicare ACO.

Researchers discovered that few ACOs using the model's capabilities to manage chronically ill patients are seeing outcomes, and the organizations are primarily utilizing current infrastructure to do so.

In addition, the ACOs linked patients to pre-existing community care services and used community healthcare workers to increase the efficacy of acute disease treatment.

Data management technologies also aided ACOs in tracking critical disease care statistics to improve population care planning and execution. ACOs also used the performance indicators to maintain and coordinate patient care throughout the healthcare ecosystem.

Caring for an individual at home can also save money by reducing readmissions and assisting the patient to monitor their diseases in relatively low settings. Almost 80% of ACO officials mentioned that home visits were used for care transitions for some patients within 72 hours after discharge. However, only 25% of ACO practices reported conducting home visits for individuals with complex medical needs during care transitions.

Developing a comprehensive implementation procedure and alerting all associated caregivers of the home care can assist ACOs in reaping the full advantages of treating patients at home. By customizing the home visit program to a specific group, the healthcare system reduced Medicare payments for their most costly individuals in 2 years.

Conclusion:

Accountable care organizations (ACOs) now must assess their present healthcare and cost-management methods, along with their healthcare information and technology solutions, to induce the performance upshots of more participants.