How to prepare for 2024 ACO success in 2023
by Michael Jones
Over the last several weeks, we’ve focused on readiness for joining an Accountable Care Organization, or ACO. We’ve explored what an ACO is, shown how to see if your practice is ready to join an ACO, and shared five key questions to assess before either forming your own ACO or joining an existing ACO.
Congratulations if you’ve gone through these steps and are now ahead of the August 1 deadline to enroll in an ACO! Depending on which route you went, either forming your own ACO or joining an existing ACO, you might feel like a flurry of activity has suddenly come to a stop, and not know what to do next, since the performance year doesn’t begin until January 1, 2024.
Regardless of which route you choose, you can do these things to prepare for maximum success before the performance year even begins.
Learn all you can about the ACO program and methodologies.
From our April 2 article, recall that there are many sources direct from CMS that will be beneficial for you:
Specifically the Current Years Shared Savings and Losses and Assignment Methodology Specifications section (current version is Version 10, which can be found here: SHARED SAVINGS AND LOSSES AND ASSIGNMENT METHODOLOGY Version 10
If you are joining an existing ACO, a monthly resource called the ACO Spotlight Newsletter, is a resource that would give you regular input on breaking topics and updates from CMS.
Take the time between now and the end of the year to educate yourself on overall ACO policies, metrics for success in an existing ACO, governance requirements, and general knowledge base areas to enter the performance year as an informed leader.
Educate your physicians and key clinical staff.
One of the biggest barriers to success in an ACO is physicians and key clinicians who have no idea that they are even in an ACO. With the general busy-ness of a primary care practice, including health plan requirements, vendor visits, staffing, and everything else it takes to just survive, often, there is little time for proactive planning and involvement among your team. The ACO program, though, is set up to reward year-over-year progress and improvement in outcomes, which can only be done through incremental, focused improvement. At the highest levels, involve your key clinicians in the “why” behind joining an ACO, and prepare clinicians for the upcoming year.
Educate your support staff.
Where your physicians and clinicians will be direct contributors to the success of your practice, your support staff will be the key to your ultimate success. Even for a single physician practice with one clinician and one office manager, involvement and awareness of the support team is crucial to your success. There will be meetings, if you join an existing ACO, or, at the very least, monthly metrics and reports to review and monitor. Knowing what your key success factors are each month, and what areas will require the most attention, are a major driver of your performance. To succeed in an ACO goes beyond merely knowing you are in the program and having your clinicians understand that you’re even in a program. Knowing what your targets are and how to hit those targets, which is something your support staff can own, is also critical.
Prepare your patients
Your patients will be required to be notified that you are participating in an ACO. There are mandated forms and methods of delivery and receipt of these forms, and the ability for patients to opt out of data sharing. Preparing your patients to understand what you are doing, and the ultimate goal of the program, which is improved health outcomes, will prepare you for future success.
Furthermore, seeing your patients for their Annual Wellness Visit (AWV), capturing appropriate condition codes and ensuring a baseline for your patients’ care, will pave the way for 2024 success in many ways.
Armed with these key areas, the next six months can move from being an often uninformed waiting period to a buildup to your future success in an ACO. Then, you and your practice can be prepared for the amazing journey in value based care that can truly differentiate you and your practice among your patients and in your community.
