For over a decade, the Medicare Shared Savings Program has participated in accountable care organization (ACO) models. As of 2022, roughly 11 million patients are attributed to ACOs, but the priorities and challenges of ACO leaders have not been fully understood.
In a new study for JAMA Health Forum, Dr. Dhruv Khullar, assistant professor of population health sciences, Dr. Amelia Bond, assistant professor of population health sciences, and colleagues characterize the perspective and experience of ACO leaders in MSSP. They conducted interviews with 49 ACO leaders, focusing on their clinical care and management efforts, distribution of shared savings, and other factors that influence their experience.
ACO leaders report several key initiatives, including annual wellness visits, coding practices, and improved transitions in care. Market competition resulting from health system consolidation, large medical groups, and the growth of the Medicare Advantage program influences retention and recruitment practices. Many leaders of hospital-associated ACOs report challenges with conflicting incentives to reach their objectives.
Results suggest that policymakers may wish to consider the strategies and challenges of ACO leaders as they reform the MSSP. Additional research can explore the outcomes of ACO initiatives, and care outcomes for patients in ACOs.
- Highlights