OIG report details common tactics used by top ACOs to save cost while improving care

The Office of Inspector General (OIG) recently reported on key tactics shared by the top 20 ACOs who are returning savings to Medicare under the Medicare Shared Savings Program.

• Work with doctors to let them know what their services and decisions cost
• Wherever possible, reduce the administrative burden on the providers to participate
• Provide data to doctors about their practices and referrals to increase awareness of cost and reveal gaps in care (and educate physicians with unusual spending or utilization)
• Encourage patients – especially those with costly chronic conditions – to get involved in their own healthcare
• Help patients avoid unnecessary hospital and ER visits by coordinating their transitions of care and promoting annual wellness visits
• Share data between providers, across EMRs or by having all providers on a single EMR
• Explicitly address patients’ behavioral health and unmet social needs

As you can see, many if not most of these tactics are supported by having a referral management structure in place to facilitate provider engagement, share clinical data across EMRs and engage the patient to make sure they follow through.