(part 3) Lessons Learned: Common Pitfalls for ACOs in MSSP and How to Avoid Them
This is the final installment in our three-part series on MSSP success. If you missed the earlier blogs, check out Blog 1 on the record-breaking 2023 MSSP results [here] and Blog 2 on the key characteristics of successful ACOs [here]. Today, we’re exploring what not to do—and how to avoid the pitfalls that trip up too many ACOs.
Success Leaves Clues. So Does Failure.
Let’s face it: participating in the Medicare Shared Savings Program (MSSP) is not for the faint of heart. The rewards are substantial, but the path is filled with challenges. For every ACO that unlocks shared savings, another struggles to meet its goals. And while each organization is unique, the mistakes that derail them are often the same.
The good news? These pitfalls are avoidable. By understanding where others have faltered, you can steer your ACO clear of the roadblocks and onto the path of sustainable success. Let’s unpack the five most common mistakes—and how to sidestep them.
1. Neglecting Primary Care: The Fatal Flaw: If primary care is the engine of value-based care, then neglecting it is like running on fumes. ACOs that fail to invest in primary care find themselves trapped in a reactive model, constantly putting out fires instead of preventing them. The result? Higher costs, poorer outcomes, and frustrated patients.
The Fix: Double down on primary care. Equip your clinicians with the resources, data, and support they need to manage patient health proactively. Embed care coordinators, leverage telehealth, and ensure patients can access primary care easily and often. Remember, every dollar spent on primary care is a dollar saved down the line.
2. Underutilizing Data: Flying Blind in a Data-Driven World: Data isn’t just a buzzword; it’s the backbone of modern healthcare. Yet, many ACOs either lack the infrastructure to collect data effectively or don’t know how to use it once they have it. This leaves them reactive, unable to spot trends, identify risks, or measure their own performance.
The Fix: Invest in robust data infrastructure and analytics tools. But don’t stop there—create a culture where data is used. Train your teams to interpret data insights, act on them, and continuously refine their strategies. Real-time dashboards, predictive analytics, and AI tools aren’t luxuries; they’re necessities for ACO success.
3. Lack of Coordination: The Cost of Fragmentation: Imagine a relay race where the runners don’t pass the baton smoothly. That’s what fragmented care looks like. ACOs that struggle with coordination experience duplication of services, missed follow-ups, and patients who fall through the cracks. The result? Higher costs and poorer outcomes.
The Fix: Prioritize seamless communication across care teams. Integrated care platforms, shared care plans, and regular team huddles can keep everyone on the same page. Patients should feel like they have one cohesive care team, not a disjointed collection of providers. Coordination isn’t optional—it’s the glue that holds value-based care together.
4. Overlooking Patient Engagement: The Missing Piece: Patients aren’t passengers in the journey to better health—they’re co-pilots. Yet many ACOs neglect patient engagement, treating it as an afterthought. The consequence? Missed appointments, poor adherence to care plans, and outcomes that fall short of expectations.
The Fix: Engage patients proactively and continuously. Personalized outreach, education programs, digital tools, and easy-to-use patient portals can make a world of difference. Meet patients where they are—whether that’s through SMS reminders, virtual visits, or community events. When patients are informed and involved, outcomes improve, and costs decrease.
5. Struggling with Digital Quality Measures: Resistance Is Futile: The transition to digital quality measures (eCQMs) and all-payer reporting can feel like an uphill battle. Some ACOs delay adopting these tools, fearing complexity or disruption. But avoiding the transition only creates more work, more confusion, and more missed opportunities.
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The Fix: Embrace digital quality measures as a way to streamline and enhance your reporting. Start with small steps: invest in platforms that integrate with your existing systems and provide ongoing training for your teams. The transition might be challenging, but the long-term efficiency gains are worth it.
Practical Strategies to Steer Clear of These Pitfalls
Knowing the pitfalls is one thing—avoiding them is another. Here are some practical strategies to ensure your ACO stays on track:
Success in MSSP requires a strategic mindset and a commitment to continuous improvement. The ACOs that learn from these pitfalls are the ones that thrive.
The Road Ahead: Success Is Within Reach
MSSP success isn’t a mystery—it’s a formula. Avoid the common pitfalls, adopt the proven strategies, and stay focused on delivering high-quality, cost-effective care. The challenges are real, but so are the opportunities.
At AaNeel, we’re here to help you navigate this complex journey. Our tools and expertise in data integration, care coordination, and quality reporting can help you avoid these pitfalls and achieve your shared savings goals. Because when you succeed, patients thrive—and that’s what it’s all about.
?? Explore how AaNeel can support your ACO’s success. [Link]