Accountable care organizations (ACOs) function to reduce health costs and provide quality care for patients within their network. Rewarding primary care physicians for focusing on preventative care is only way an ACO can help their partners save money. Sometimes, however, a specialist is needed for their expertise, which is frequently more expensive than a primary care visit. So, how can ACOs implement cost-saving strategies when it comes to specialists? Here are a few ways ACO leaders have begun integrating specialty care while maintaining reasonable costs:
- ACO administrators may not be able to immediately begin integrating specialists so some start by influencing referrals. After considering the practice patterns of available specialists, they can encourage primary care physicians to refer patients to specialists with less resource-intensive tendencies.
- Some ACOs have also started including primary care physicians in quarterly reports and meetings. This lets physicians voice their concerns and fill in the gaps when necessary. Having representatives from all departments such as IT, finance, and analytics is a great way to facilitate collaboration towards the same goals.
- Encouraging preventative healthcare strategies is another great cost-saving method. Healthy patients are less likely to require the expensive expertise of a specialist so preventative medicine is beneficial for the budget as well as the patient.
- Analyzing the data of specialists and providers within an ACO’s network will indicate where more work is needed to alleviate costs and improve care. By taking the data into consideration, ACOs can determine where the quality of care and spending isn’t up to the standards of high quality care.
- Helping patients understand the importance of preventative care also helps improve cost-effectiveness. At Catholic Benefits Trust, we help reduce costs and increase the quality of care by coordinating patients with nurse advocates to help them navigate the complex medical system. You can contact us to learn more about our services and nurse advocacy.
You can successfully integrate value-based specialty care into your ACO by sharing, negotiating, and collaborating with all members and partners of your organization. Having everyone the same team and analyzing relevant data is the first step towards creating a cost-effective quality-care organization.
What does your ACO do to improve quality and value for members while integrating specialty care?