How Do Accountable Care Organizations Deliver Preventive Care Services? A Mixed-Methods Study

Area of Science:

• Health Services Research
• Preventive Medicine
• Healthcare Management

Background:

• The Affordable Care Act incentivizes preventive care through Accountable Care Organizations (ACOs).
• Understanding how ACOs deliver these preventive services is crucial but not well-documented.

Purpose of the Study:

• To investigate how Medicare ACOs deliver preventive care services to their attributed patient populations.

Main Methods:

• A mixed-methods approach combining survey data from 283 Medicare ACOs with 39 interviews across 18 high-performing ACOs.
• Surveys assessed ACO capabilities in care management and quality improvement; interviews explored mechanisms and motivations for delivering preventive care.

Main Results:

• ACOs engaged in comprehensive care management, including preventive care reminders, had more beneficiaries but not necessarily higher quality scores or shared savings.
• High-performing ACOs utilize annual wellness visits and systematic approaches to close preventive care gaps.
• Few initiatives specifically target clinically complex patients within ACOs.

Conclusions:

• ACOs are increasingly driven to offer preventive care services.
• Understanding the strategies of high-performing ACOs can inform providers and payers on enhancing preventive care utilization.