January 17, 2017
According to a recent viewpoint in the American Journal of Managed Care, accountable care organizations (ACOs) must learn to embrace and foster better patient-centered care in order to succeed at reducing costs and improve care value.
The viewpoint noted that patient-centered care was once proclaimed to be a core health system and despite being one of the most-used terms still in health care, it is one of the most misunderstood terms.
“Although [patient-centered care] was proclaimed a core health system aim in a 2001 Institute of Medicine report, the term too often involves a series of aspirational statements about respect for patient values that give rise to widely different interpretations that are more ‘turn of phrase’ than ‘term of art,’” Joel S Weissman, PhD, associate professor of health care policy at Harvard Medical School, and colleagues wrote in the viewpoint commentary.
The term patient-centered care is often ambiguous, but according to the viewpoint, “Medicare accountable care organizations must find a way to turn ideal into real.” ACOs require protocols to ensure strong patient-centeredness, including requiring a beneficiary of the ACO to sit on the advisory board.
To evaluate and better understand patient-centered care, researchers conducted qualitative interviews with 15 top ACOs across the United States. The interviews revealed a disconnect between practical patient engagement efforts and those called for by policymakers.
The criteria for each ACO that researchers spoke to, “had a 3-pronged, practical approach: 1) engaging patients, as partners, with ACOs, thus ensuring that patients are activated, engaged in their care, and share decision-making power; 2) a proactive, customer-service orientation, making care convenient and accessible, and reaching out to patients—especially to those with chronic illness; and 3) individualized care coordination, with a whole-person orientation, tailored to the patient’s unique needs across settings and over time, with family and caregivers included, as appropriate.”
According to the researchers, ACO leaders emphasized that patient-centered care strategies cannot be a “one-size-fits-all,” despite the fact that they are often treated like that. For example, larger ACOs were able to leverage health technology for high-risk patients. By using data analytics, the larger ACOs were able to identify chronically ill patients and treat them accordingly. Comparatively, smaller ACOs require staff members to search through data to identify high-needs patients themselves. Larger ACOs are also able to create practice-wide care improvement goals and train leaders in attaining those goals.
“Overall, turning a provider-centered organization into a patient-centered one means linking high-level leadership and goal-setting to practical actions, cumulatively meant to ensure that patient-centeredness would take root,” concluded the authors.