As a top performer in year one of the CMS Pioneer ACO program, Monarch HealthCare is paving the way to accountable care with a foundation of patient- and provider-centered strategies that support Triple Aim goals. Here, Colin LeClair, executive director of ACO for Monarch HealthCare, recounts lessons learned from that first year, including the initial one: patient engagement remains a challenge.
In terms of lessons learned, patient engagement remains challenging. Patients and physicians often don’t agree with how they’re aligned, so you often hear physicians saying, ‘I haven’t seen that patient in three years.’ That’s entirely possible, because the algorithm to attribute patients to a doctor goes back three years.
We also found in our experience in year one that 70 to 80 percent of ACO patients’ office visits are with specialists. We don’t have any specialists in our aligned network, so that is very challenging.
Patients continue to be suspicious of ACO services. They don’t understand the value of “care coordination,” so it’s hard to demonstrate tangible value to them.
But we do know that they are most likely to engage if their physician endorses the ACO, and also if they have recently been discharged from the hospital, so that’s where we have to focus.
Patient resistance, as you might expect, is reportedly driven by fear of change in benefits. They think they’re being dropped into an HMO with limited options. They are afraid of losing their freedom of choice, and afraid of being taken advantage of.
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