Participating in a physician-led accountable care organization can be an alternative for independent physicians who don’t want to consolidate with a hospital or health system.
Indeed, physician-led ACOs show promising results and in various studies outperform ACOs led by hospitals and other large medical organizations. They also can provide a way for practices to handle increasing government regulation and can help with the administrative burden that comes with quality data reporting under the Medicare Access and CHIP Reauthorization Act. There’s also strength in numbers in pooling resources to pay for technology, such as electronic health records.
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In a piece for NEJM Catalyst, authors Natacha Lemaire, of the French Ministry of Health, and Sara L. Singer, Ph.D., a professor of medicine at the Stanford University School of Medicine, talked to leaders of ACOs participating in the government’s Medicare Shared Savings Program (MSSP) that were composed of networks of individual physician or small group practices. The early experience of successful MSSP ACOs are useful for other ACO leaders, they wrote.
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They asked the leaders of 13 ACOs in eight states to describe the benefits and challenges they face. Those leaders described three keys for success for independent physicians who want to start an ACO:
1. Focus on building leadership and staff in the first years of the ACO. With that main objective, there is no immediate need for massive investment in infrastructure of information technology.
2. Establish close relationships between practices and ACO leaders. This allows the ACO to develop programs to address problems and needs of the participating practices. “This is particularly important at the beginning to build trust and engagement,” the authors said.
3, Stay focused on a small number of priorities. ACOs should not try to do everything at once. Leaders suggested a step-by-step approach, starting with specifying roles and responsibilities at the primary care level. Then put basic organizational elements in place so the ACO can fulfill care management functions such as annual awareness visits and chronic care and transitional care services.