ACOs can do more to promote population health
While accountable care organizations (ACOs) are playing a key role in promoting population health, one public health official thinks these organizations haven’t reached their full potential as agents of change that can improve health outcomes for groups of patients in geographic locations.
Karen Hacker, MD, director at Allegheny County Health Department, told Medical Economics that the attention ACOs pay to high-cost patients that are chronically ill has limited the potential and scope they have to affect the health of groups of patients beyond those under their care. The Pittsburgh-based organization promotes public health by supporting individual and community wellness programs for more than 1.2 million county residents in southwestern Pennsylvania.
“ACOs tend to focus on keeping subgroups of patients – patients with diabetes, cancer, hypertension and others chronic illnesses – out of the hospital,” Hacker said. “If ACOs want to push population health further along, they’ll have to design a strategy with a geographic focus that goes beyond the patients they claim responsibility for.”
Because ACOs are comprised of a group of healthcare providers that work in an integrated care delivery system who share responsibility for the medical care, management, costs and quality outcomes of a designated group of patients, they can provide a platform from which to launch an effective population health strategy.
In 2013, Hacker wrote a policy paper for the American Journal of Public Health entitled: “Achieving Population Health in Accountable Care Organizations.” In that document, she called for ACOs to develop community partnerships to support prevention activities. While there has been progress since then, Hacker said, ACOs can and should do more.
For example, if a large population of diabetic patients lives in a geographic area where it’s difficult for them to purchase fresh fruits and vegetables at a nearby store, an ACO could partner with healthcare stakeholders to invest in a grocery store that provides that produce.