
Inspector General of HHS Praises Strategies Used by ACOs to Shift to Value-Based Care
A new report from the HHS’ Office of the Inspector General praises 20 high-performing accountable care organizations (ACOs) for the strategies they are using in the shift to value-based care.
CMS should support the efforts that accountable care organizations (ACOs) are making to cut unnecessary costs and improve the quality of care.
That’s according to
ACOs also described how they have managed to address and overcome challenges in each of these areas.
In its continued effort to focus on paying for value rather than the volume of healthcare services,
The report was praised by the National Association of ACOs (NAACOS), which said that it can take as long as 4 years before ACOs achieve savings. “Achieving success is an iterative process that takes time learning what works and what’s needed within an organization and community and is made harder by the lack of a ‘one-size-fits-all’ strategy,” Clif Gaus, ScD, president and chief executive officer of the organization,
NAACOS called the report “a roadmap for success in accountable care that should be read by policymakers and ACOs alike.”
“As CMS carries out this and other ACO programs and develops new alternative payment models, it should support the use of these strategies and other successful strategies that emerge,” the report said. “These strategies can apply not only to ACOs but also to other providers committed to transforming the healthcare system toward value.”
CMS, saying it concurred with the 7 recommendations made by OIG, said it is already taking steps to implement the changes.
The recommendations from the OIS say CMS should:
- Review the impact of programmatic changes on ACOs’ ability to promote value-based care
- Expand efforts to share information about strategies that reduce spending and improve quality among ACOs and more widely with the public
- Adopt outcome-based measures and better align measures across programs
- Assess and share information about ACOs’ use of the skilled nursing facility 3-day rule waiver and apply these results when making changes to the Shared Savings Program or other programs
- Identify and share information about strategies that integrate physical and behavioral health services and address social determinants of health
- Identify and share information about strategies that encourage patients to share behavioral health data
- Prioritize ACO referrals of potential fraud, waste, and abuse
Medicare spending is expected to exceed $1.5 trillion by 2028, more than double the $708 billion in spending in 2017.
Newsletter
Stay ahead of policy, cost, and value—subscribe to AJMC for expert insights at the intersection of clinical care and health economics.