A recent paper “Realizing the Promise: Overcoming the Barriers to ACO Success” explores the promises, doubts, hopes, and future of accountable care organizations (ACOs), with the caveat “it is imperative that you proactively position your organization to take advantage of this opportunity. . . . The number of lives covered through ACOs is anticipated to grow exponentially, reaching more than 105 million patients by 2020, compared to just over 20 million today.”
But me being a staff member of the Baldrige Performance Excellence Program, I was struck by this nist-quote, “The success of any ACO really comes down to the culture. Creating an environment that encourages effective behavior and best practices happens through open, transparent, and passionate leadership.”
While the work of creating and sustaining an ACO seems daunting, the Baldrige Excellence Framework (Health Care) can help—with redefining a culture, creating an environment for effective leadership and behavior, and sharing best practices. The bottom line, Baldrige resources support and enable high-performing ACOs. For example, category 1 of the Criteria (within the framework) provides all of the considerations that leaders need for creating a successful organization now and in the future: an environment for the achievement of your mission, improvement of organizational performance, transparency, organizational learning, and learning for people in the workforce. The Criteria also include considerations for creating a workforce culture that fosters customer engagement, an environment for innovation, and a culture for patient safety.
According to the white paper, “ACOs brought to reality by the Affordable Care Act were designed with a promise: by banding together, physician organizations, hospitals, and other care delivery organizations could share risk, reduce costs, and deliver better holistic care to their patient populations. For a vast majority of ACOs, however, those shared savings have yet to materialize—leaving many doubting that this program solves health care challenges around care coordination and sustainability. There’s still hope, however, for the success of ACOs. Their structural ability to deliver on the tenets of the triple aim— improve the patient experience of care, improve population health, and reduce costs —is strong.”
The white paper lays out four critical barriers to success:
For an ACO to succeed, according to the white paper, organizations need to improve the patient experience of care, improve population health, reduce costs, integrate physicians, and ensure that every member of their team understands (or at least appreciates) the importance of quality data (and how they should be gathered, normalized, and made actionable).
I might add one more: implement the Baldrige framework as a roadmap to ensure that you are considering all of these elements to succeed as an ACO. Also, apply for a Baldrige Award so that you can receive objective feedback from Baldrige Examiners on how you are doing to achieve your goals.
What other elements of the Criteria do you think could help health care organizations succeed as ACOs?