ACO Toolkit for Effective Provider Engagement Strategies

The third in a series of CMS created toolkits, the report features innovative strategies Medicare ACOs use to help primary care and specialty providers in the ambulatory setting improve healthcare quality and patient outcomes.

The Center for Medicare and Medicaid Services (CMS) designs the reports for public consumption to help educate Americans on the actionable ideas ACOs have and intend to implement to enhance value-based care as well as to help current and prospective ACOs with their operations. The toolkits feature insights gathered during CMS-sponsored learning system events and through focus groups with the ACOs. For this most recent addition the agency conducted focus groups and individual interviews with representatives from 22 ACOs that participate in the Medicare Shared Savings Program and in the Next Generation ACO Model.

In exploring the development and implementation of the ACOs’ provider engagement strategies, this toolkit looks at how ACOs:

• Communicate with providers about the ACO as a value-based care organization
• Use data to identify and address opportunities for improving care
• Offer customized support to primary care providers (PCPs) and specialists
• Implement financial incentives

National Law Review provides more detail on the toolkit, here’s a summary of the highlights of the key strategies ACOs may implement when communicating their organizational goals with providers.

Leverage leadership to promote culture change and utilize visual tools

ACOs’ focus on changing the culture emphasizes promoting new behaviors that are both related to population health and required for navigating the transition to value-based care, including coordinating care, engaging beneficiaries, and making community-based supports available to address the social determinants of health.

Create clear and multiple lines of communication about the shift to value-based care.

…ACOs use multiple forms of communication when they engage providers in value-based care operations and when they describe their approaches to improving the delivery of care. These include written electronic communications, podcasts and online trainings, and interactive meetings.

The report also coaches ACOs on how to use data to identify and address opportunities for improving patient care.

Develop and deliver provider-level feedback and action-oriented reports

ACOs encourage individual providers to share feedback reports with office staff who play critical roles in the delivery of care, including practice managers, nurses, and administrative staff. As experts in practice operations, these staff offer valuable insight into what strategies can move the needle on providers’ performance on key measures.

The report also includes a section on customizing support for primary care and specialist providers.

Despite the somewhat different concerns voiced by PCPs and specialists when discussing approaches to population health, ACOs have found that similar strategies are effective in supporting both types of providers. Many ACOs offer individual providers access to hands-on guidance and coaching to help them identify and test initiatives that are intended to make the delivery of care as efficient and effective as possible.

The Toolkit concludes with a section on financial incentives motivating providers to help ACOs improve the quality of care for their beneficiaries and meet thresholds for achieving shared savings.

The National Law Review summarized,

• ACO board members and other stakeholders should work collaboratively to determine the proportion of shared savings to allocate to shared saving payments, to ACO infrastructure, and to redesigning care processes.
• Evaluate which metrics to use for awarding shared savings payments based on the availability of data, the strength of the evidence base that underlies the metric, the ability of clinicians to take action to improve their performance, the conciseness of the overall measure set, and the alignment with measures used in other value-based contracts.
• Reevaluate benchmarks for shared savings metrics to ensure that they are ambitious enough to encourage ongoing quality improvement.

Download the July toolkit from CMS

Two other CMS ACO toolkits are also available including the agency’s Care Coordination and Beneficiary Engagement series.