Milbank Memorial Fund, John A. Hartford Foundation, Commonwealth Fund Support Study That Reveals How ACOs Use Home Visits to Improve Care and Reduce Hospital Use
A new Dartmouth-led study, published this week in the June issue of Health Affairs, offers new details about how one key approach–home visits–is helping many ACOs improve care management and identify patient needs while aiming to reduce hospital use. The study was part of a broader set of research based at Dartmouth focused on how ACOs care for patients with complex clinical and social needs.
ACOs–groups of physicians, hospitals, and other healthcare providers who voluntarily form partnerships and agree to take responsibility for meeting certain quality and total costs of care measures–may employ a variety of strategies, approaches, and processes to meet their goals. Over the past decade, they have played an increasingly prominent role in efforts to reform the American healthcare system.
“We focused on ACOs because we felt that their responsibility for total costs of care might motivate them to implement care delivery innovations that otherwise might be too resource-intensive,” explains lead author Taressa Fraze, PhD, a research scientist at The Dartmouth Institute for Health Policy and Clinical Practice.
The researchers used national survey data from physician practices and ACOs, paired with qualitative interviews with 18 ACOs across the country to learn more about home-visiting programs.
They found that the majority of ACOs believed that home visits were valuable–80 percent reported using home visits within 72 hours of post-discharge for at least some of their patients. These ACOs were more likely to be larger and part of a system, including a hospital, and to participate in risk-bearing contracts or other payment reforms. They also found that physician practices with ACO contracts were more likely to report using home visits for care transition than non-ACO practices...