Partners at the ACO table

February 15, 2012

CMS is encouraging healthcare providers to improve the quality of care and reduce costs through a collaborative approach, 1 of which is the accountable care organization. Many realize that pharmacists have an important role to play in the success of these models of care.

The diversity in the organization of U.S. healthcare often leads to fragmented patient care, payment, and delivery systems. In many settings, the responsibility of steering the health of a community or a patient is disseminated across many sites. One potential solution is the accountable care organization (ACO), a new form of provider, which was established with the passage of the Affordable Care Act. ACOs are 1 way that the Centers for Medicare and Medicaid Services (CMS) is encouraging hospitals, physicians, and other providers to improve the quality of care, and reduce costs through a collaborative approach.

At the 2011 American Society of Health-System Pharmacists (ASHP) Midyear Clinical Meeting, Kevin Colgan, MA, FASHP, corporate director of pharmacy at Rush University Medical Center in Chicago, Ill., and past ASHP president, said that the triple aim goals of the ACO program are to focus on better care, better health for populations, and lower per capita costs.

Similarly, Colgan believes that although the focus is on physicians and hospitals, pharmacists can play an integral role in the success of ACOs by identifying high-risk patients and developing individualized care plans, promoting evidence-based medicine, and coordinating care. He also pointed out that some concerns of the ACO model have included the amount of risk inherent in the ACO initiative, retrospective assignment of certain Medicare beneficiaries, number of quality metrics, and the Medicare Shared Savings Program rate.