Practical ACO Success Strategies For Health Systems

Accountable Care Organizations link payments to patient outcomes and cost savings rather than service volume. Health systems in ACO programs need ACO Success Strategies for clinical quality, financial performance, and care coordination. Medicare Shared Savings Program ACOs earned $4.1 billion in shared savings in 2024. ACOs that perform well focus on primary care, data analytics, team-based care, and patient engagement. These organizations invest in infrastructure for population health management.

1. Building Primary Care Foundations

Primary care drives ACO performance. ACOs with more primary care physicians save more money than those with fewer primary care doctors.

Primary care requirements:

• Hours during evenings and weekends
• Teams with nurses, pharmacists, and social workers
• Behavioral health in primary care offices
• Care managers for high-risk patients
• Same-day appointments when needed

2. Integrating Data and Analytics

Data runs every ACO operation. Organizations must see clinical patterns, cost drivers, and quality measure performance.

Multi-Source Data Integration

ACOs pull data from EHRs, claims systems, lab results, and pharmacy records. This makes complete patient profiles showing all care across settings. EHR data gives diagnoses, medications, and vital signs for chronic disease tracking. Claims data shows utilization and costs by service. Lab results show test outcomes and screening rates. Pharmacy data tracks medication adherence and drug interactions.

Analytics platforms must show performance against benchmarks continuously. Monthly reports arrive too late.

3. Managing Care Transitions

Hospital-to-home transitions create high risks for readmissions. Poor transitions waste money through penalties and repeated hospital stays.

ACOs run formal transition programs. These programs collect hospital discharge information, check medications, and screen for complications after discharge. Care managers call patients within 48 hours of leaving the hospital.

Health information exchange alerts tell primary care providers when patients visit hospitals or emergency departments. This starts an immediate follow-up.

4. Quality Measure Performance

Quality scores directly affect ACO shared savings eligibility. Medicare requires ACOs to meet quality thresholds before paying any shared savings.

ACOs track HEDIS measures, patient satisfaction scores, and preventive care completion continuously. Staff see which patients have open care gaps and call them.

Methods include:

• Quality measure tracking in EHR workflows
• Patient registries for chronic conditions
• Staff assigned to close care gaps
• Same-day services for overdue screenings
• Automated reminders for preventive care

5. Provider Engagement and Culture Change

Physician leadership drives ACO success. Providers must understand why clinical changes matter and see how changes affect outcomes and finances.

Culture change needs:

• Regular performance feedback to providers
• Transparent data on costs and quality by physician
• Financial incentives tied to quality and cost

Take Action Now!

Persivia's platform supports health systems with ACO Success Strategies. The system pulls clinical and claims data from multiple sources into complete patient profiles. Risk tools find high-risk patients who need intensive management. Quality tracking monitors HEDIS, MIPS, and other metrics continuously with automatic care gap identification. 

Visit Persivia to see how population health platforms support ACO operations.