Factors Influencing Rural Hospitals to Participate and Remain in Accountable Care Organizations
Emily J Lawton1, Jenah McCarty2, Thomas E Vaughn1
1Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City, Iowa, USA.
Summary
Rural hospitals consider financial incentives, value-based care, population health, resources, and external factors when joining accountable care organizations (ACOs). Concerns about risk may lead to withdrawal from ACO models.
Area of Science:
- Health Services Research
- Healthcare Policy
- Rural Health
Background:
- Rural providers face unique challenges in healthcare delivery.
- Accountable Care Organization (ACO) models aim to improve value-based care but rural participation remains unclear.
Purpose of the Study:
- To investigate factors influencing rural hospitals' initial and continued participation in Medicare and commercial ACO models.
- To explore policy implications for enhancing rural provider engagement in ACOs.
Main Methods:
- Conducted semistructured, in-depth interviews with rural hospital executives.
- Utilized thematic analysis on transcribed interview data informed by a codebook.
Main Results:
- Key participation drivers include financial incentives (shared savings, funding), strategic positioning for value-based care, population health improvement capacity, resource gains, and external factors.
- ACO design significantly impacts rural providers' model selection and timing.
- Concerns regarding risk in ACO models were raised, potentially leading to disengagement.
Conclusions:
- Qualitative findings offer crucial insights for increasing rural participation in value-based care initiatives.
- Understanding these factors is vital for improving healthcare quality in rural communities.
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