How to approach an ACO

If you have decided that joining or contracting with an ACO is right for you, the next step is to attract and start building a relationship with an ACO that will best fit your practice environment. When reaching out to prospective ACOs, remember to:

Do your research

Much like interviewing for a company, do some research about the ACO you are approaching to learn more about the organizational culture, values, and goals. Are they aligned with yours? Did the entity apply for CMS’s ACO Medicare Shared Savings Program (MSSP) or does it plan to apply? Did the ACO operate as an integrated care system prior to becoming an ACO? What are/were their experiences in this system? How many physicians have joined? Are there any dermatologists? If so, how many are there and how many referrals do they get? How many Medicare beneficiaries does the ACO serve? How does the ACO intend to deliver dermatologic care?

In addition to researching the ACO, learn more about the patient community within that ACO to determine where you can provide value. Talk with the members of the ACO to learn about populations of patients that could be at risk for melanoma and could benefit from the quality preventive care that dermatology provides. Also, ask them how many subsets of patients have eczema, psoriasis, or other conditions that are best treated by dermatologic care. 

Essentially, in doing a little digging about the ACO and its beneficiaries, you can identify areas in which dermatology can complement and enhance patient care.

Demonstrate quality of care

Recently, there has been a shift within the health system environment that emphasizes the need for more cost-effective and quality care. The final Patient Protection and Affordable Care Act stipulated that MSSP ACOs report on 33 quality measures that would be phased in during the three-year ACO contract. Although many of those measures are not germane to dermatology, there are several that could apply. 

The 33 quality measures fall within four domains, one of which focuses on patient/caregiver experiences. Individual measures under this domain — that may be applicable to dermatology — rely on patient ratings and perceptions of:
  • Timeliness of care, appointments, and information.
  • Effectiveness of doctor-to-patient communication. 
  • Access to specialists.
  • Emphasis on health promotion and education.
  • Shared decision-making between doctor and patient.
Other quality measures that may relate to dermatologic care involve coordination of care and overall patient safety — emphasizing medication reconciliation and qualifying for EHR incentive payments.

When approaching an ACO, it may be helpful to have documented how you have met these quality measures in your practice in the past, and emphasize the value you can bring to an ACO. 

Promote the unique specialty of dermatology

Much like providing a resume or curriculum vitae in an interview, when approaching an ACO, share studies and documentation that demonstrate how dermatology is uniquely prepared to provide cost-effective and quality care for skin diseases and conditions.

The American Academy of Dermatology Association offers several materials that emphasize the value of dermatological care:

Be proactive and build rapport

Possibly one of the most effective ways to attract a prospective ACO is to build relationships with participating members. There are several actions you can take to display your value and interest in serving on a team. Work more closely with primary care physicians by providing consults. When given referrals, see the patient in a timely fashion and report back to the referring doctor shortly after the visit. Make sure to provide care to referred patients regardless of payment source. Also, consider seeing patients and doing consults within the hospital setting. Taking these proactive steps to build trust and relationships with other physicians can provide proof that you are well-equipped to serve as a vital member of a team.