ACOs using medical home physicians save money, yield higher quality, report finds

The Patient-Centered Primary Care Collaborative (PCPCC) and the Robert Graham Center recently released their 2018 Evidence Report. In it, the organization found that Medicare accountable care organizations (ACOs) with a higher proportion of physicians who have patient-centered medical home (PCMH) experience tend to generate more savings and demonstrate higher quality scores than other ACOs who have fewer physicians specializing in this field.

PCMH is a care delivery model in which the patient’s primary care provider coordinates that patient’s care. The system is designed to produce coordinated, team-based holistic treatment. PCMHs and ACOs were created separately but they both have the same focus on outcomes-driven care.

In a recent panel discussion, Aledade CEO Farzad Mostashari; Robert Mechanic, exeutive director of the Institute for Accountable Care; Mai Pham, vice president of provider alignment solutions for Anthem; IBM Watson Health Deputy Chief Health Officer and Lead Population Health Officer William Kassler; and Anna Hwang, director of the Center for Consumer Engagement in Health Innovation, talked about the report and the importance of PCMH and ACOs.

The report also found that there are six domains that contribute to successful ACOs—with success defined as shared savings, improved quality or effective use of healthcare services. Those six areas are leadership and culture, prior experience, health IT, care management strategies, organization and environmental factors, and incentive and payer alignment.

From a provider perspective, Aledade CEO Farzad Mostashari says two things are part of the equation: total cost of care accountability and voluntary alignment of practices. Successful ACOs must be a coalition of the willing, Mostashari says, since the “whole dynamic of the network is incredibly powerful.”

When asked to identify obstacles to ACO and value-based progress, the panel provided many answers including sluggish public policy, increasing consolidation threatening competition (as Mostashari said, “If you’re big, you don’t have to be good.”), and binary or reductive analytic results.

For more information about the report and the panel discussion, read the article on Healthcare Dive.