The RUPRI Center for Rural Health Policy Analysis policy brief “Facilitating the Formation of ACOs in Rural Areas” (www.ruralhealthresearch.or/publications/931) discusses how little is known about rural sites included in ACOs and how to attract more rural providers. Authors include Jure Baloh, MHA: Xi Zhu, PhD: Tom Vaughn, PhD; A. Clinton MacKinney, MD, Keith J. Mueller PhD: Fred Ullrich, BA: and Matthew Nattinger, MS.
The brief discusses the four ACOs serving Medicare beneficiaries including providers with previous organizational integration experience. Three of the ACOs include providers with experience in risk-sharing arrangements and all four ACOs have established partnerships in their local and regional communities. In all four ACOs, the providers forming the ACO shared the same EHR system enabling care coordination, population health management, quality improvement efforts, and quality reporting.
Three of the four ACOS are developing telehealth capabilities designed to improve access and increase care delivery value especially in rural areas. For example, one ACO has established a diabetes prevention program using telehealth to offer diet and exercise advice to pre-diabetic patients in rural communities. In partnership with an Alzheimer’s community coalition, the ACO has also established a telehealth program offering psychiatry visits with providers from another state.
According to the brief, rural providers interested in forming or participating in an ACO should consider several issues. First, they should develop core structures and capabilities including analytic and communication tools that support population health management, quality improvement and reporting, and care coordination.
Secondly, rural providers interested in forming or participating in an ACO should engage partners previously involved with integration and risk sharing so they can provide necessary financial management expertise.
It is also a good idea to partner with organizations outside of healthcare, service organizations, or local businesses that can provide opportunities for identifying critical needs and address population health in innovative ways.
The RUPRI Center for Rural Health Policy Analysis at http://cph.uiowa.edu/rupri is based at the University of Iowa in the Department of Health Management and Policy at the College of Public Health.