Effective care management is the answer to ACO success
In August, the Centers for Medicare and Medicare Services (CMS) reported that the Accountable Care Organizations (ACOs) participating in the generated more than $411 million in total savings in 2014, which includes all ACOs’ savings and losses. Of those, 97 ACOs qualified for shared savings payments of more than $422 million by meeting quality standards and their savings threshold.
Leaders from these ACOs attribute their organization’s ability to reduce costs and share savings while improving care quality to better care management, particularly involving transitions from the hospital to home or a post-acute care setting, according to a study commissioned by CMS.
However, survey results show effective care management was not shared by all the ACOs. Many ACOs were unable to effectively access and share timely data to help monitor and report on patients. A key differentiator among the experienced ACOs in this study, as well as other provider organizations proficient at care management, is that their care coordinators are supported with information technology tools that are able to capture data from around the care continuum, stratify patient risk and deliver actionable insight to help engage patients, avoid readmissions and prevent adverse events.