Best Practices for Creating an Accountable Care Organization

The U.S. healthcare system is moving toward Accountable Care Organizations (ACOs), groups of healthcare providers who agree to be accountable for the quality, cost, and overall care of Medicare patients. In the video series “Expert Perspectives on ACOs,” healthcare industry thought leaders recommend the following best practices when forming ACOs:

  1. Create a readiness checklist.
    “A readiness checklist...involves things like patient-centered medical homes and the attributes that primary care physicians have,” said Robert J. Jackson, MD, MMM, president and medical director, Accountable Healthcare Alliance in Michigan. “It talks about, ‘How well do we deal with data? Do we have patient registries? Do we have patient care plans? Do we have transition of care issues developed?’”
  2. Meet patients’ specific needs.
    “The key is designing the care management tools, resources, people, and interventions to manage the specific needs of that patient,” said Laura P. Jacobs, MPH, executive vice president, The Camden Group in California.
  3. Develop clinical integration.
    “Make sure all the providers are engaged in real-time information sharing so a care plan can be developed within a very quick period of time and all the providers know their roles and the timelines in which they have to perform their services,” said Michael H. James, JD, president and CEO of Genesys PHO, a pioneer ACO, and Genesys Integrated Group Practice in Michigan.
  4. Engage the community.
    “The community has to…support programs that improve health and improve the way patients live because healthcare goes beyond just acute care,” James said. “It involves the patients’ safety, whether they have enough to eat, their transportation, education, business opportunities, or employment opportunities.”
  5. Select the right board members.
    “A pioneer ACO requirement is to expand the board with a patient and a community advocate,” James said. “Genesys…selected the leader of their volunteer group. He is 72 years old and is very engaged and involved in community studies on how to improve access to care. The community advocate is the executive director of a group of nursing homes.”

The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider in light of all circumstances prevailing in the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.

12/15

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