Top 5 Most-Read AJAC Articles of 2020

In 2020, articles published in The American Journal of Accountable Care® (AJAC) explored drivers of success in accountable care organizations (ACOs), responses to payment reform efforts, and more.

Here are the 5 most-read articles published in AJAC in 2020.

5. Leveraging Health Information Technology for ACO Success

The author of this Insights article explains how health information technology (IT) can enable ACOs to transition away from traditional siloed care to a more coordinated model by allowing for easier data sharing and reporting. For instance, one ACO invested in an IT solution to supplement claims information and provide actionable insights for clinicians at the point of care. Health IT can compile information in nearly real time, which may help clinicians keep patients out of the hospital and avert unnecessary utilization.

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4. Hospital Responses to DSRIP Program Reforms in New Jersey

How do hospitals respond to new initiatives that rethink reimbursement to tie funds to quality outcomes? The authors of this research study aimed to answer this by surveying hospitals about their responses to and perceptions of the Delivery System Reform Incentive Payment (DSRIP) program, and the answers revealed that the perceived benefit of DSRIP project activities, as well as of data sharing, increased over time. DSRIP was thus successful in accelerating hospitals’ evolution toward data-driven population health care, they conclude.

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3. One Size Will Not Fit All: Factors That Drive Strategy in Accountable Care Organizations

ACOs have meaningful differences in many characteristics, including the clinical and social complexity of their populations and how their network is configured, so applying the same strategy to all ACOs will not yield success, according to this Insights piece. For example, care management interventions should emphasize management of multiple chronic diseases in Medicare populations, whereas that strategy may not be as beneficial in commercial populations. The type of clinical pathways designed and implemented within ACOs will also vary by the types of care sites and specialty practices situated within their networks.

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2. Implementation of Pharmacist-Driven Comprehensive Medication Management as Part of an Interdisciplinary Team in Primary Care Physicians’ Offices

This Reform Trends article reports on the outcomes of an effort to integrate pharmacists into interdisciplinary care teams, where they can perform comprehensive medication management to address any barriers to patients taking their prescribed medications. In this health system that participates in an ACO, pharmacists provided 836 recommendations over a 3-month period and more than 90% of patients agreed the pharmacists helped them feel confident managing their medications. Additionally, 93% of prescribers agreed that their patients benefited from the pharmacist’s help.

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1. Accountable Care Organizations and Patient-Centered Medical Homes: Health Expenditures and Health Services

ACOs and patient-centered medical homes (PCMHs) have both gained attention as possible solutions to ever-growing health care expenditures, and this article assesses their effect, both separately and in combined hybrid models. The investigators found that care received in ACO and PCMH facilities is associated with lower total care costs than standard care, but hybrid models actually had slightly higher costs than stand-alone models. They called for further evaluation of health care delivery and reimbursement innovations.

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