• Hector P Rodriguez, Bing Ying Poon, Emily Wang, and Stephen M Shortell.
• Center for Healthcare Organizational and Innovation Research, University of California, Berkeley.
• Milbank Q. 2019 Sep 1; 97 (3): 692-735.

AbstractPolicy Points Accountable care organizations (ACOs) have incentives to promote the adoption of patient engagement strategies such as shared decision making and self-management support programs to improve patient outcomes and contain health care costs. High adoption of patient engagement strategies among ACO-affiliated practices did not improve patient-reported outcomes (PROs) of physical, emotional, and social function among adult patients with diabetes and/or cardiovascular disease over a one-year time frame, likely because implementing these strategies requires extensive clinician and staff training, workflow redesign, and patient participation over time. A dominant focus on improving clinical measures to meet external requirements may crowd out time needed for care team members to address other outcomes that matter to patients, including PROs. Payers and policy-makers should explicitly incentivize the collection and use of PROs when contracting with ACOs.© 2019 Milbank Memorial Fund.

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