title: An Early Assessment of Accountable Care Organizations' Efforts to Engage Patients and Their Families.
abstract: Accountable care organizations (ACOs) have incentives to meet quality and cost targets to share in any resulting savings. Achieving these goals will require ACOs to engage more actively with patients and their families. The extent to which ACOs do so is currently unknown. Using mixed methods, including a national survey, phone interviews, and site-visits, we examine the extent to which ACOs actively engage patients and their families, explore challenges involved, and consider approaches for dealing with those challenges. Results indicate that greater ACO use of patient activation and engagement (PAE) activities at the point-of-care may be related to positive perceptions among ACO leaders of the impact of PAE investments on ACO costs, quality, and outcomes of care. We identify a number of important practices associated with greater PAE, including high-level leadership commitment, goal-setting supported by adequate resources, extensive provider training, use of interdisciplinary care teams, and frequent monitoring and reporting on progress.
authors.affiliation: University of California, Berkeley, CA, USA Center for Healthcare Organizational and Innovation Research, Berkeley, CA, USA shortell@berkeley.edu.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Shortell
authors.affiliation: University of California, Berkeley, CA, USA Center for Healthcare Organizational and Innovation Research, Berkeley, CA, USA.
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Sehgal
authors.affiliation: University of California, Berkeley, CA, USA Center for Healthcare Organizational and Innovation Research, Berkeley, CA, USA.
authors.forename: Salma
authors.initials: S
authors.lastname: Bibi
authors.affiliation: University of California, Berkeley, CA, USA Center for Healthcare Organizational and Innovation Research, Berkeley, CA, USA.
authors.forename: Patricia P
authors.initials: PP
authors.lastname: Ramsay
authors.affiliation: University of California, Berkeley, CA, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Neuhauser
authors.affiliation: Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA.
authors.forename: Carrie H
authors.initials: CH
authors.lastname: Colla
authors.affiliation: Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA.
authors.forename: Valerie A
authors.initials: VA
authors.lastname: Lewis
mesh_terms: D060866:Accountable Care Organizations; D003657:Decision Making; D006801:Humans; D058991:Patient Protection and Affordable Care Act
keywords: accountable care organizations; mixed methods; patient activation; patient engagement; shared decision making