How to Improve Your ACO? Just Ask

By Shanti Wilson

Accountable care organizations (ACO) are the mechanism, in public and private settings, to meet both healthcare quality and cost reduction goals. As of January 1, 2020, nearly every U.S. state had at least one public or private ACO, according to recent CMS data.

With ACOs firmly entrenched within the U.S. healthcare system, ACO administrators in recent years have focused their success and performance metrics on financial, quality, and care coordination measures. Yet an entire range of key performance data is also available from ACOs’ most readily accessible information resource: their patients.

By directly querying patients and taking appropriate follow-up measures based on patient feedback—including informing patients of feedback-driven changes—ACOs can ensure they are properly serving their clientele. Moreover, as ACO patient satisfaction also affects financial and quality metrics, improving patient satisfaction directly impacts ACO finances. The key is regularly measuring and assessing patients’ experiences and using that information to quickly follow up. Here’s how to measure your ACO’s performance based on patient feedback.

Where to start?

Assessing ACO performance need not be complicated. Fundamentally, most ACO patients simply want to share their perspectives on such questions as:

  • Do I have swift access to the care I need?
  • Do I feel supported in my health goals by my healthcare practitioners?
  • Am I taken care of properly when I am sick?
  • Do I receive the healthcare information I need to properly affect my care?
  • Overall, am I happy with the care I’m receiving?

While these are all basic questions, they may be complicated to address across large integrated networks. For instance, if your patient feedback is indicating that patients wish to gain better access to care, determine if your clinical hours align with the populations you serve.

For example, a standard general practitioner shift (Monday through Friday, 8 a.m. to 5 p.m.) may work well for your Medicare population. However, most patients with full-time jobs and/or long commutes will be unable or unwilling to come in for clinical visits that consume a good portion of their workdays. If a substantial number of patients are saying that your operating hours don’t work for their schedules, determine how you can address their interests.

Assess patients’ in-person and digital care availability options to ensure you’re meeting their access needs and expectations. Additionally, be sure your patients have access to the specialists and care teams they need to support their health. Patient input is just as important when it comes to specialists as it is for generalists. ACOs seeking to provide optimal service should strive to meet patients as they live, not require them to accommodate clinical schedules unaligned with their lives.

Assist with patients’ health goals 

A greater emphasis on preventive medicine increases the need for ACOs to deliver high-quality risk assessment and goal-setting services to patients. To support patients’ health goals, determine if your care team has processes to document these goals, assist with patient counseling/consulting relative to these goals, and determine if the goals are readily achievable. Ask your patients about their health goals, then follow up accordingly.

For example, a patient may initially state a desire to lose 50 pounds to keep from developing diabetes, based on his family’s health history and his own clinical tests and input. The care team might suggest breaking this total weight loss goal into 10-pound increments over the next several months. Thus, the patient’s care plan becomes a living document that is updated and refined as goals and needs change.
Prepare to deliver when needed
The occurrence and recurrence of many patient illnesses and ailments can often be predicted based on time of year and typical patient activities. How are you ensuring proper care and treatment when patients seek predictable services?

From seasonal illnesses to sports-related injuries to cardiac-related events, patients need to know whom to call, where to go, and how they will be cared for when they need to talk to or see a physician in your system. Are you prepared to deliver the services that your patients expect, based on their input, at a time and place when they need it?

Remember, your patients are not living in a health information vacuum with your organization as their sole information provider. Rather, they are bombarded with input about healthcare treatment options from both you and other clinical care providers, as well as from online and media sources, friends, and family members. If you have, for example, a parent whose young, feverish child is wailing and pulling at her ears at 1 a.m., likely all that parent wants from you at that time of night is readily accessible information to resolve this issue. Are you prepared to deliver it?

Patients with chronic healthcare needs may want ongoing input on topics such as staying healthy and preventing certain types of diseases. If your chronically ill patients are making these requests, determine if such information is readily available and understandable when and where they need it.

Patients expect high levels of customer service from the healthcare industry, which is why it’s unsurprising that, nationally, providers’ Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys often fall below targets. However, while CAHPS data is useful, it’s just one component in assessing your organization’s operating performance.

By seeking to directly hear the voice of your patients based on the types of service you provide, you will be much better prepared to improve your patient experience and satisfaction. Correspondingly, any improvements you make in these areas will also likely benefit your bottom line.
Shanti Wilson is a consultant with Freed Associates, a California-based healthcare management consulting firm.