By better aligning incentives, the new MCO-based DCE type encourages partnerships with healthcare providers to implement care coordination programs that can improve quality and reduce Medicare FFS spending. Nonetheless, many healthcare entities are taking a “wait and see” attitude about the Direct Contracting Model.

CMS has signaled that it is genuinely looking to improve care quality and not just check a bunch of boxes. Some organizations may see the recent changes as generally beneficial in requiring less administrative work. However, some new reporting burdens may not be readily apparent.


Many organizations are still trying to figure out how they will manage outside of their ACO businesses. Some are struggling because, while they’ve invested in significant technology to manage their ACOs, they don’t have interfaces to connect every practice everywhere.
So, what should ACO decision-makers do now? Here are four strategies:

First, stick to the basics. That means continuing to focus on effectively managing and engaging with your individual patients and enabling population management by segment. I have been to many ACO conferences and have found that the most innovative strategies are usually the most foundational.

Second, don’t allow uncertainty to immobilize your organization on the road to value-based care (VBC). It’s better to embrace greater financial risk on your own terms than wait to have it thrust upon you by CMS or other payers.

Third, maintain (or develop) a commitment to community-based care. Social determinants of health (SDOH)—social, behavioral, and environmental factors—account for 80% of health outcomes. ACOs should collaborate with community-based organizations that support higher-risk patients. They also should deepen their relationships with their patients using digital communications tools such as secure email, texting, or voice messaging to interact with patients and influence treatment plan adherence and lifestyle changes.

Finally, ACOs today must have a powerful analytics platform with robust data aggregation that can turn data into actionable information. ACOs should ensure their IT systems are providing the necessary insights to support participating providers in improving performance. When your organization is embracing financial risk, visibility into quality and cost metrics is essential. ACOs need to identify negative trends and take early corrective action to protect their shared savings or VBC payments and improve patient outcomes.

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