My name is Clare Nolan and I work for Harder+Company Community Research, a national consulting firm that specializes in evaluation. For the past 27 years, we have helped foundations, government agencies, and nonprofits plan and evaluate programs and policies.
Accountable Care Organizations (ACOs) mark a new frontier in how healthcare is delivered in the United States. ACOs create incentives for health care providers from different organizations to work together to treat individual patients across care settings. Our firm recently conducted an evaluation of California’s first ACO which serves more than 40,000 members of the California Public Employees’ Retirement System (CalPERS), the nation’s second largest purchaser of healthcare services.
Lesson Learned: The concept of Triple Aim is a key framework for evaluating the success of health reform. However, it takes time for ACOs to develop the legal and analytical infrastructure necessary to support analyses of these data. In the near term, evaluation can play a potentially more valuable role by providing formative feedback on the effectiveness of inter-organizational collaboration among ACO partners. Our evaluation of the CalPERS ACO identified the following as core competencies for ACO success:
- Leadership and commitment. Having executive leaders across partner organizations that are invested in the success of the ACO and demonstrate consistent levels of commitment.
- Accountability and governance. Establishing inter-organizational governance systems that enable collaborative decision-making, promote accountability, and support communication.
- People and teams. Staffed by individuals who are action-oriented, knowledgeable, and strategic, and managed by empowered leaders with a strong clinical background.
- Data and information technology. IT systems that enable seamless data-sharing and information exchange that enables patient-level care coordination.
- Communication. Honest, open, and transparent communication that supports learning and problem-solving across organizations.
Rad Resource: The surge of interest in ACOs prompted by health reform has resulted in an explosion of new literature. We found the following articles helpful because they focus less on ACO development and more on implementation.
- Accountable Care Organizations: A New Model for Sustainable Innovation
- A Framework For Evaluating The Formation, Implementation, And Performance Of ACOs
- Large-System Transformation in Health Care: A Realist Review
Hot Tip: Evaluators can play a strong role in supporting transformations in the health care system that lead to expanded healthcare access and improved overall health status.
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