Meaningful Engagement of ACOs With Communities: The New Population Health Management. Issue 11 (November 2016)

• Record Type: Journal Article
• Authors: Hefner, Jennifer L; Hilligoss, Brian; Sieck, Cynthia; Walker, Daniel M.; Sova, Lindsey; Song, Paula H.; McAlearney, Ann Scheck
• Is Part Of: Medical care. Volume 54:Issue 11(2016)
• Publication Date: 2016-11
• Subjects: Accountable Care Organizations -- population health management -- health services research -- qualitative; Economics, Medical -- Periodicals; Insurance, Health -- Periodicals; Santé, Services de -- Administration -- Périodiques; Soins médicaux -- Périodiques; Medical economics -- Periodicals; Health insurance -- Periodicals; Medical economics -- United States -- Periodicals; Health insurance -- United States -- Periodicals; Comprehensive Health Care -- Periodicals; Personal Health Services -- Periodicals; Gezondheidszorg; Économie de la santé -- Périodiques; Santé, Services de -- Périodiques; Health insurance; Medical economics; United States; Periodicals; 362.10973
• DOI: 10.1097/MLR.0000000000000622
• Languages: English
• ISSNs: 0025-7079

Abstract

Abstract : Objectives: Population health management (PHM) activities within health care organizations have traditionally focused on coordinating services for populations who present for care in physicians' offices. With the recent proliferation of Accountable Care Organizations (ACOs), however, the reach of PHM has expanded. We aimed to study ACOs' evolving definitions of their patient populations, and how these definitions might be linked to different types of PHM activities pursued by ACOs. Methods: Over a 2-year period, we conducted in-depth case studies of 4 ACOs operating in the private sector, including 149 interviews with 89 informants. Although the main study focused on the ACO implementation process, our use of both inductive and deductive qualitative methods enabled us to study emergent topics such as we report here about PHM. Results: Interviewees across sites described their ACO populations using terms indicating both panel management and community/neighborhood involvement in the context of PHM. Further, all 4 sites reported conducting PHM activities that extended beyond traditional provider-based PHM; these ranged from wellness registries to school-based clinics. Executives at all 4 ACOs also discussed providing, or planning to provide, health care services to all community members in local settings. Conclusions: Administrators and physicians in private sector ACOs were proponents of ACO-led programs delivered in community settings that provided health care to all members of the community, and reported their ACOs engaged in multisector collaborations designed to improve neighborhood health. These community engagement activities point to a distinction from 90s era managed and integrated care organizations and may contribute to the sustainability of the ACO model. Abstract : Supplemental Digital Content is available in the text.