Introduction
Accountable Care Organizations (ACOs) have emerged as a pivotal element in the transformation of healthcare delivery, aiming to enhance care coordination, reduce healthcare costs, and improve the overall quality of care. Despite their potential, ACOs face significant challenges in engaging patients effectively. Improving patient engagement in ACOs is crucial for the success of these models, as highlighted by a recent report from the Health Care Transformation Task Force (HCTTF) and the National Association of ACOs (NAACOS). This blog delves into how ACO models can improve to support patient engagement by focusing on communication, benefit design, and patient input.
The Role of Communication in ACO Success
Greater success in ACOs is linked to flexible beneficiary communication policies. Effective communication can bridge the gap between patients and ACOs, ensuring that patients are fully aware of the benefits and functions of ACOs. Jeff Micklos, executive director of HCTTF, emphasized the importance of patient engagement, stating, “Effective patient engagement is paramount to the success of ACOs.” Strengthening Medicare policies to enhance communication and awareness among beneficiaries can significantly improve patient engagement.
Enhancing Beneficiary Engagement
Boosting Beneficiary Communication and Education
One of the primary challenges ACOs face is the limited awareness among beneficiaries about their participation in ACOs. Health plans and ACOs often hesitate to communicate with patients about their enrollment due to CMS’s stringent classification of such communications as marketing materials, which historically required CMS approval. This approval process has slowed efforts to disseminate essential information about ACO benefits.
The report suggests that CMS could align communication policies with those governing Medicare Advantage, granting more flexibility in how ACOs communicate with their beneficiaries. This approach would enable ACOs to develop population-specific communication plans, focusing on storytelling rather than bureaucratic language, to enhance beneficiary understanding and engagement.
Engagement in Care Delivery Redesign
ACOs aim to improve patient access to primary and preventive care. However, many of the tools developed for this purpose do not adequately consider patient needs and preferences. For instance, limitations on primary care provider access and digital literacy barriers can hinder patient engagement and care access.
MSSP requires patients to select their primary care providers via the MyMedicare.gov website, which can be problematic for individuals with limited internet access or digital health literacy. The task force recommends simplifying waivers and involving beneficiaries in the design of these tools to promote a person-centered approach.
Allowing ACOs to waive cost-sharing, improving the primary care selection process, and ensuring that ACOs are aware of which individual clinicians beneficiaries visit are central strategies for enhancing engagement in care delivery.
Incorporating Patient Input in ACO Governance
Currently, ACOs are mandated to include at least one Medicare beneficiary in their governing body. However, this requirement poses challenges, including difficulties in recruiting individuals due to experience and time constraints. Additionally, ACOs struggle to meet patient-centeredness criteria due to a lack of guidance and resources.
Task force members highlighted that having a beneficiary on the ACO governing board is not sufficient for obtaining comprehensive patient feedback. Initiatives such as patient and family advisory councils provide a more effective platform for patients to discuss their needs. Furthermore, community hub collaborations have proven beneficial in helping ACOs engage with and gather feedback from the community.
The task force advocates for a more flexible approach that prioritizes best practices over rigid requirements, allowing ACOs to tailor their strategies to their specific populations.
Conclusion
Improving patient engagement in ACOs is essential for the success of these healthcare models. By enhancing communication and education, redesigning care delivery with patient needs in mind, and incorporating patient input into governance, ACOs can better engage patients and improve care outcomes. Adopting these recommendations will help ACOs overcome current barriers and pave the way for a more patient-centered approach to healthcare.
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FAQs
Q: What are Accountable Care Organizations (ACOs)?
A: ACOs are healthcare models designed to improve the quality of care, reduce healthcare costs, and enhance care coordination.
Q: Why is patient engagement important in ACOs?
A: Patient engagement is crucial for the success of ACOs as it ensures patients are aware of and can benefit from the coordinated care and preventive services offered by ACOs.
Q: How can ACOs improve communication with beneficiaries?
A: ACOs can improve communication by adopting more flexible communication policies, aligning with Medicare Advantage, and focusing on storytelling to enhance beneficiary understanding.
Q: What role do patient and family advisory councils play in ACOs?
A: These councils provide a platform for patients to discuss their needs and offer feedback, helping ACOs to better understand and address patient concerns.
Q: What are some challenges ACOs face in engaging patients?
A: Challenges include limited patient awareness, digital literacy barriers, and difficulties in incorporating patient input into ACO governance.
