Provider Collaboration Needed to Drive Patient Experience, ACO Success

In order to ensure accountable care organization (ACO) and patient experience success, providers must collaborate across the continuum of care, suggested a recent study out of the Ohio State University Fisher College of Business.

“We found that if an ACO wants to be successful, it needs representation across all parts of a patient’s continuum of care,” Aravind Chandrasekaran, the study’s leader, said in the press release. “But that’s a large challenge. It’s easy when you look at a group of physicians or hospitals; they all speak the same language, have the same forms and records system. But when you start adding skilled nursing facilities or other services, this collaboration becomes more difficult.”

“Think about a patient who is discharged from a hospital and is told to schedule follow-up services,” Chandrasekaran continued. “If their provider doesn’t provide those services, or it’s difficult to access them, they’re not going to do the therapy or the follow-up services. This leads to readmissions ( ie patients admitted to a hospital again for the same condition.”

Researchers examined factors that could assist ACOs in providing more efficient, effective, and satisfactory health outcomes. In addition, the study calculated the cost associated with such advancement to ACO performance. 

To study the impact of partnership scope and scale on ACO performance, the researchers used data from 528 Medicare Shared Savings Program (MSSP) ACOs between 2013 and 2016.

The study findings showed that an ACO with partners from all three care continuum stages—pre-acute, acute, and post-acute—could improve patient experience quality by 5.3 percent and reduce the 30-day readmission rate by 2.9 percent. 

However, a partnership scope which is the presence of providers across the continuum of care’s three stages yielded better outcomes.

ACOs with provider partnerships across the continuum of care sparked an improvement in patient experience of 3.2 percent and a 6.6 percent reduction in 30-day readmission rates. In addition, researchers discovered that an average-sized MSSP ACO that discharges 5,360 patients annually could potentially have 354 fewer readmissions

“This is even more important because other research has shown that more than 60% of ACOs have providers from only one care-continuum stage,” Chandrasekaran stated.

However, facilitating provider collaboration comes at a cost. During the first year of implementation, the per-capita expense for covering the entire continuum of care is expected to increase by 12 percent, equaling nearly $1,422 per patient, the report stated.

Researchers predicted the increase in spending will decrease over time.

“There is a cost-quality tradeoff, but if ACOs are persistent and implement changes properly, those changes will pay off, and that tradeoff will disappear,” Chandrasekaran said. “This research further shows that health care is a system; it’s not individual parts. If you want good health care, it’s more than just having great doctors. It means excellence and collaboration across all three aspects of that continuum of care.”