ACO Challenges and How to Address Them

The state of healthcare is shifting from fee-for-service reimbursements to value-based accountable care organization (ACO) initiatives. While the concept of ACOs is still evolving, the goal has continued to focus on effective coordination of care while avoiding unnecessary costs. However, challenges arise when transitioning to this model of care despite the many benefits it offers.

Here are 3 challenges the ACO atmosphere faces and what can be done to solve them.

One challenge affecting ACOs is the lack of a standardized EHR systems across multiple providers. Ideally, an ACO would be founded upon a single infrastructure through which primary care providers could synchronize patient data amongst each other. The reality is that providers are often using separate EHR systems while facing financial burdens to overcome this challenge.

The solution would be to implement health information exchange technology to promote coordination between providers. Investments from third party payers will help provide information sharing and analytics across multiple systems. This would reduce discrepancies in data reporting on different systems.

Another challenge is the standardization of treatment guidelines and quality measures that an ACO requires in order to benefit from value-based reimbursements. Providers may already be burdened with the pressures of utilizing their knowledge and skills to provide critical patient care. Add to that the balance of handling cost effective treatments and applying the correct administrative coding procedures, value-based systems can become complicated for provider care.

Defining patient care plans and applying new improvements in management tools may be the solution to this challenge. Providers should work to develop specific metrics to evaluate patient care and track them using integrated management systems.

The third challenge of ACOs is the need for access to patient clinical information. Providers under an ACO must have access to a patient’s complete medical history in order to find and treat gaps in care. Access to clinical data will allow for proper assessments in care while reducing the need to acquire charts from other providers.

The solution to this challenge would be to incorporate management tools that support real-time clinical alerts and predictive analytics. The tracking and reporting of patient data across a uniform system can help providers focus on treating patients consistently while also personalizing care.

There are many advantages to the accountable care model. However, standardized infrastructures and data access is crucial for the coordination of providers to deliver information that is practical for patients, clinicians, and public health agencies.