As collaborative groups of physicians, hospitals and other health care providers voluntarily working together, accountable care organizations (ACOs) deliver well-coordinated, high-quality care to patients and represent a shift toward a more integrated and efficient health care system.

With ACOs becoming important allies for many clinicians, it’s no surprise that the Centers for Medicare and Medicaid Services (CMS) has committed that by 2030, all Medicare beneficiaries will be in a care relationship creating accountability for quality and total cost of care, making ACOs a central pillar of CMS’ strategic vision.

That begs the question: With so many options, how can a skilled nursing provider know if they’re choosing the right ACO for their patients?

The answer lies in finding a partner that meets these six criteria:

1. Patient-centered. The most important piece of the ACO puzzle is improving patient care. Evidence of thoughtful design in care delivery, elements of patient equity and a track record of improved clinical outcomes will help validate if an organization’s work is aligned with the kind of care a practice wishes to provide. 
2. Clinician-focused. The proliferation of ACOs can make care delivery feel more like business than like health care. Clinicians are the backbone of delivering care and integral to the heightened patient engagement that can result in success. Asking about an ACO’s clinician leadership and clinician-centered workflows will give quick clues as to whether an organization is seeking to solve clinical conundrums on the way to shared savings.
3. Technology-forward. Health care in the 21st century is data-driven and evidence-based. Looking for partners who leverage point-of-care tools, real-time analytics and seamless data-sharing can make the process of change management a breeze. ACOs that can work with a skilled nursing facility’s current electronic health record (EHR) and billing vendors can often make many processes operate smoothly. 
4. Process-driven and transparent. Successful ACOs have strong internal processes to share performance data regularly with transparency. Furthermore, look for evidence of thought partnership in translating the data into meaningful next steps that will help a practice succeed. These can be in the form of regular meetings, practice improvement tools, coding or documentation education.
5. Financially sound. Shared savings is the central tenet of partnerships within ACOs. Look at the fine print for any reporting commitments, performance thresholds and claw-backs. As they say, there are no free lunches. If it looks too good to be true, it probably is.
6. Relationship-builders. ACOs are about partnership. Long-term and mutually beneficial relationships can be built over an ACO’s agreement period. Selecting the right partner is often about the right fit — ask for references to hear firsthand experience.

The Sound difference: Inside SLTCM, a leader among high-needs ACOs

Eager to support an often-underserved patient population, Sound Physicians established Sound Long-Term Care Management (SLTCM) in 2023.

“By ensuring timely and appropriate care, especially for those with chronic conditions, SLTCM’s goals are those of most ACOs: help our partners improve patient experience, enhance care delivery, prevent unnecessary service duplication, and minimize medical errors,” says Dr. Sandeep Yadavalli, Associate Chief Medical Officer for SLTCM.

Sound set SLTCM as an enhanced-track Medicare Shared Savings Program ACO to serve individuals nationwide who have the highest unmet needs. What sets them apart is what they bring to their partners, including:

• Enhanced track. Leveraging the deep expertise of the ACO leadership team in value-based care, Sound is confidently enrolled in the highest-risk track on offer — the enhanced track — where they are eligible for 75% of first-dollar savings. 

• Physician leadership. SLTCM is unique in that it’s led by tenured clinicians with deep experience in value-based care and innovation. This allows them to approach care from their partners’ perspectives, working together to define goals, design workflows and identify challenges. Furthermore, with full-time dedicated clinical leadership, SLTCM is committed to being thought partners to their participating provider groups through a regular cadence of performance meetings and data sharing. 
• An innovative care model. SLTCM’s care model includes the below four pillars:

1. Proactive care. By leveraging annual wellness visits, best practices on chronic conditions, and creating unique specialty partnerships, SLTCM focuses on elevating what is commonly known as usual care in these facilities.
2. Telemedicine. Bringing virtual care to the bedside in long-term facilities means real-time access to a clinician who can potentially treat a patient in place and reduce avoidable transfers to the emergency department. The impact on patient and clinician satisfaction is immense.
3. Point-of-care tools. SLTCM employs tools that overlay usual clinician workflow in major EHRs to bring real-time visibility to risk adjustment, quality gaps, and patient risk scores without the need to leave their usual electronic workspace.
4. Chronic care management (CCM). Paired with proactive clinical care from primary teams, CCM can reduce decompensations of chronic illnesses, which account for most avoidable health care costs.

“SLTCM has the distinction of achieving an exceptional reporting rate in our first performance year,” Yadavalli says. “We’ve built a strong team with intimate knowledge of EHRs, coding systems and reporting registries to demystify quality reporting for our partner providers.”

This article is sponsored by Sound Physicians. To learn more about SLTCM, visit soundphysicians.com/sltcm-aco and enroll.