Are accountable care organization (ACO) leaders really ready to take on all the patients attributed to themeven the most challenging ones? The question is far from abstract. Indeed, the further that patient care organization leaders push into risk-based contracting, the clearer certain challenges become. Thats especially true as ACOs grow larger in size and inevitably take on both bigger populations and find themselves with more and more Medicare and commercial health plan members who have greater medical needs.And into that breach has come a new study, published in the Health Affairs Blog last week. The authors of a study based on a survey of ACO leaders are finding significant but highly addressable gaps in caring for high-need, high-cost individuals in ACOs. Indeed, Janet Niles, Teresa Litton, and Robert Mechanic, in their article, An Initial Assessment of Initiatives to Improve Care For High-Need, High-Cost Individuals In Accountable Care Organizations, point to a range of possible strategies in this area.The authors state that Accountable care organizations (ACOs) are well positioned to serve the HNHC high-need, high-cost population more effectively and have financial incentives to do so. ACO payment models incorporate annual global budget targets for defined beneficiary populations. ACOs can earn shared savings payments by controlling spending below their target budget. Although the ACO model is relatively new, ACOs already care for more than 32 million covered lives across all payer types. ACOs have a strong interest in improving care for this population and are required by regulation to provide person-centered care.

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