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Are ACOs Ready to be Accountable for Medication Use?

Robert W Dubois1, Marv Feldman2, Adam Lustig3

  • 1Chief Science Officer, Health Services Research, National Pharmaceutical Council, Washington, DC.

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|October 29, 2020
PubMed
Summary

Accountable Care Organizations (ACOs) show readiness in some medication management areas but have critical gaps in demonstrating value and preventing polypharmacy. Further development is needed for optimal patient outcomes and cost savings.

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Area of Science:

  • Health Services Research
  • Pharmaceutical Policy
  • Healthcare Management

Background:

  • Accountable Care Organizations (ACOs) aim to reduce costs and improve care quality through coordinated efforts.
  • Optimal pharmaceutical use is a key but often overlooked component for ACO success.
  • Challenges exist in integrating medication management into the ACO model.

Purpose of the Study:

  • To assess the preparedness of ACOs in maximizing medication value for quality and cost goals.
  • To identify strengths and weaknesses in ACO medication management capabilities.

Main Methods:

  • An electronic self-assessment tool was developed and piloted with ACO representatives.
  • The survey, based on the National Survey of Accountable Care Organizations and original questions, was distributed to 175 ACOs.
  • A convenience sample of 46 ACO representatives completed the assessment (26% response rate).

Main Results:

  • ACOs reported high readiness in electronic prescribing (70%) and integrating medical/pharmacy data (54%).
  • Significant improvement areas include quantifying cost offsets (7%), physician notification of prescription fills (9%), protocols for polypharmacy (17%), and diverse quality metrics (22%).
  • Many ACOs lag in fully utilizing health information technologies for medication value.

Conclusions:

  • Developing robust medication use support, monitoring, and assurance is crucial for ACO success and patient outcomes.
  • Existing health IT adoption in ACOs is not fully leveraged for medication management.
  • Case studies are being developed to guide ACOs in addressing medication-related challenges and achieving the "triple aim".