Accountable Care Organizations and Occupational Therapy

Area of Science:

• Healthcare Management
• Value-Based Care Models
• Chronic Disease Management

Background:

• Accountable care organizations (ACOs) were established by the Patient Protection and Affordable Care Act to shift Medicare from fee-for-service to value-based purchasing.
• ACOs aim to reduce healthcare expenditures for Medicare beneficiaries while improving care quality, with a focus on chronic care management.
• Occupational therapy practitioners (OTPs) are increasingly recognized for their potential role across the care continuum within ACOs.

Purpose of the Study:

• To examine the opportunities for occupational therapy (OT) to contribute to ACO quality outcomes and value-based care.
• To identify barriers hindering the full utilization of OTPs within ACOs and other alternative payment models.

Main Methods:

• This article reviews the existing literature and discusses the integration of OT services within the ACO framework.
• It analyzes the alignment of OT's evidence-based, client-centered approach with ACO goals for cost reduction and quality improvement.
• Barriers to OTP integration in value-based care models are considered.

Main Results:

• OTPs can significantly contribute to ACOs' quality outcomes and value-based care goals through specialized interventions.
• Client-centered and evidence-based occupational therapy can enhance patient engagement and functional independence, aligning with ACO objectives.
• Existing barriers may limit the optimal integration and utilization of OT services within ACOs.

Conclusions:

• Occupational therapy offers valuable contributions to the success of Accountable Care Organizations in achieving quality and cost-efficiency goals.
• Addressing barriers to OTP utilization is crucial for maximizing their impact within ACOs and other value-based healthcare models.
• Increased inclusion of OT services can position them as a vital component of successful value-based care delivery.