ACO patients report higher satisfaction, better care coordination

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Seniors are more satisfied with their healthcare and believe it is more coordinated if their providers are part of an Accountable Care Organization, according to first-of-its-kind research from the Harvard Medical School Department of Health Care Policy.

Medically complex patients with multiple conditions reported particularly significant improvements in care quality, the investigators determined.

Established under the Affordable Care Act, ACOs are groups of providers that can share in Medicare savings if they deliver high-quality care while reducing costs, such as by integrating their services more effectively. Given that post-acute and long-term care is an important part of this integration, many providers have either joined ACOs or are seeking to align themselves for future participation.

Some providers have stayed on the sidelines in part because outcomes have been mixed. Some ACOs have improved quality outcomes but have not been able to reign in costs. And many initial participating providers have dropped out of the Pioneer ACO program, designed for healthcare systems that already had a high level of integration.

The Harvard findings show that from the beneficiaries' perspective, ACOs are delivering on their promise of improved care. The study authors emphasized this, but acknowledged that the model is far from perfect.

“While these early findings are encouraging, there is a pressing need for regulatory and legislative changes to strengthen ACO incentives, expand provider participation in new payment models and address potential downsides of provider integration, such as higher prices,” stated lead author J. Michael McWilliams, M.D., Ph.D. “Our study suggests a promising start, but there is a long road ahead.”

McWilliams and his colleagues analyzed Medicare claims and beneficiaries' responses to the Consumer Assessment of Healthcare Providers and Systems survey. They compared satisfaction scores of 32,000 ACO beneficiaries with a demographically and geographically matched group of 250,000 beneficiaries not in ACOs.

Complete findings were published online Thursday in the New England Journal of Medicine.