ACOs and value-based care in 2024: Four key questions and answers

ACOs have long been at the front lines of value-based care efforts. In a recent LinkedIn Fireside Chat, Andy Dé sat down with David Bartley and Brian Norris to discuss how critical ACOs are to the success of value-based care, and what role the current healthcare environment is playing in that relationship.

1: How are accountable care organizations (ACOs) a part of the value-based care picture?

ACOs are groups of providers who collaborate to coordinate high-quality care for Medicare patients. They are well-positioned to optimize care delivery and reduce costs—two major goals of value-based care—and have been highly influential in the development of value-based arrangements. We are still in a period of experimentation with ACOs, however, continuously testing out various models and collecting comprehensive data on their outcomes. Recently, CMS reported that the Next Generation ACO Model (2016 to 2021) yielded a 1.9% reduction in spend (~$270 per member per year). We expect to see several more models emerge in the coming years as the transition from fee-for-service to value continues, each building on the shortcomings and successes of the previous iterations to create greater well-being across diverse communities.

2: What role does data play in ACO success within value-based care?

In reflecting on the performance of the Next Generation ACO Model mentioned above, over 66% of groups described gains in data analytic capacity as the most significant change they had undergone over the course of the model. In value-based care, that advanced capacity is crucial for successful collaboration and alignment across involved entities. Strong, flexible analytics is the basis for strategic, scalable action and measurable outcome improvement.

3:  For ACOs, what are the implications of value-driven initiatives around health equity and regulatory changes regarding social determinants of health?

From our perspective, changing expectations and regulations mean that now ACOs are actually more incentivized to focus resources on underserved communities. First, CMS is paying providers to do social determinants-based assessments twice a year. Second, payers are collecting more robust population data to construct better value-based networks. Third, organizations outside of healthcare are eager to be involved in improving health equity (e.g., Uber partnering with care organizations to get patients to appointments).

4: How are successful ACOs integrating technology into their value-based care strategy?

When ACOs adopt innovative, flexible tools, they’re better equipped to adapt to regulatory changes and make big strides in value-based care efforts. Interoperable, secure platforms for integrating and analyzing patient clinical and claims data are a huge asset to ACOs, as are AI-enabled capabilities for managing revenue cycle and building strong care networks. In short, there are a lot of pieces in a value-based care puzzle. Technology helps fit them together.

For more, watch the Fireside Chat below to hear more from our experts and glean key insights for your value-based care strategy.

Want to see more on how MedeAnalytics can help your ACO advance value-based initiatives this year? Let’s chat!

Editorial Team

MedeAnalytics is a leader in healthcare analytics, providing innovative solutions that enable measurable impact for healthcare payers and providers. With the most advanced data orchestration in healthcare, payers and providers count on us to deliver actionable insights that improve financial, operational, and clinical outcomes. To date, we’ve helped uncover millions of dollars in savings annually.

Get our take on industry trends

Why Healthcare Should “Double-Down” on Exploring AI-powered BI for Reporting

October 29, 2019

Many areas in healthcare rely not only on the collection of data but, importantly, the ability to decipher and act upon it. In that intersection, reporting was born.

Read on...

Why Health Plans and Employers Need Stop Loss Reporting

September 10, 2019

Due to rising healthcare costs and the Affordable Care Act removing the ban on capitated benefits coverage, numerous employers with self-insured health plans often purchase stop loss coverage. This coverage is not medical insurance; but rather, it’s a financial and risk management tool that protects the employer from excessive claims.

Read on...

Bridge the Payer/Provider Data Gap

August 23, 2019

Every patient has a plethora of data associated with their health record, which can include decades of enrollments, claims, accounts and charges. Much of this data is not housed within the same institutional, facility or provider database…

Read on...

Digging deeper: Leveraging analytics to boost service line profitability

June 19, 2019

Regardless of the size of the hospital or health system, you need to look beyond traditional operational metrics to fully understand your organization’s performance. Insights into revenue, volume, cost, quality and variation across service lines are key to improving both performance and profitability.

Read on...