Meaningfully Engaging Patients in ACO Decision Making

Matthew DeCamp, Jeremy Sugarman, Scott Adam Berkowitz
2015 American journal of accountable care  
Accountable care organizations (ACOs) aim to improve quality and slow the growth of healthcare costs by making clinicians, hospitals, and other healthcare providers jointly accountable for the health outcomes and expenditures of their patients. 1,2 When ACOs meet quality and cost benchmarks, they can share in the cost savings accrued. ACOs are forming rapidly in the public and private sectors; more than 400 ACOs already cover more than 7 million beneficiaries in Medicare alone. 3 Engaging
more » ... ts (ie, incorporating patients' needs, values, and preferences into healthcare decision making) is considered necessary for ACOs to succeed 4,5 and is an ethical obligation of healthcare organizations. 6 Patient engagement is important in 3 distinct domains: individual patient-clinician interactions, organizational or "system-level" governance, and the broader community (ie, patients and organizations beyond the ACO). 7 Engaging patients in their individual care interactions is crucial for empowering patients to achieve better health in ways that are consistent with their values; here, ACOs are no exception. 8, 9 Engaging with the broader community beyond the ACO is also considered necessary for ACOs to improve population health. 10, 11 However, despite a regulatory requirement for involving patients in the governance of Medicare ACOs, what constitutes effective engagement in this regard has received relatively little attention. 12 We describe how ACOs can achieve meaningful system-level patient engagement. The Importance of System-Level Engagement System-level engagement can serve both practical and ethical aims for ACOs. Practically, as shown for patient safety and quality programs, 13 system-level engagement should help ACOs design care programs and set priorities (eg, about which quality or cost areas to
pmid:29057390 pmcid:PMC5647154 fatcat:3oin7aewifer3ktyglhwabev7e