Profiling ACO Success: What Drives High Performance in the MSSP?

Overview

What distinguishes a high performing Accountable Care Organization (ACO) from a low performing one? Is there a list of key ingredients that can predict success?

While the answers to these questions are not simple, it is important for any value-based organization to understand what the right levers are that impact the greatest change for their populations, reduce unnecessary spending, and provide the highest quality of care. ACOs need to consider not only the patient population they are serving, but the entire market including provider network selection, health system saturation, and geographic landscape.

We share examples of building a powerful:

Primary Care Foundation:

• What does the utilization of services for an attributed population look like?
• How do you find the top-performing providers to build strong preferred provider & facility networks?

Performance Improvement Strategy:

• Where are the biggest quality gaps and which expenditure categories contribute to high or low spend?
• How to involve prominent physician leaders in the performance conversations with physicians and share transparent performance data?

Care Coordination Model:

• What types of care coordination programs should you implement (AWV, TCM, ACP, etc.), and for which segments of your population?
• Are you routing patients towards the highest value Specialists?