How Accountable Care Organizations Are Caring for People with Complex Needs


Accountable care organizations (ACOs) and other emerging models of health care delivery and payment present an opportunity to provide better care at lower cost for people with complex needs, including those with multiple chronic conditions, behavioral health problems, and social service needs.

Today, the six-foundation collaborative committed to improving care for people with complex needs has released a new report examining how ACOs approach care for this population. The study, based on national survey data, is sponsored by the Commonwealth Fund, The John A. Hartford Foundation, Milbank Memorial Fund, the Peterson Center on Healthcare, the Robert Wood Johnson Foundation, and The SCAN Foundation. The collaborative previously developed the Better Care Playbook, an online resource widely used by health systems, providers, and others.

Researchers at the Dartmouth Institute for Health Policy and Clinical Practice find that most ACOs have comprehensive chronic care management processes or programs in place to manage care for complex needs. But few of these organizations report deploying more labor-intensive interventions like advanced programs for engaging people receiving care, in-home visits after hospital discharge, or evidence-based services for people who need mental health or addiction treatment.

While ACOs have increased their efforts to target populations with complex care needs, the authors say many could do more to adopt evidence-based strategies, especially regarding patient identification, patient engagement, and care transitions.

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