New Toolkit Highlights How Medicare Accountable Care Organizations Engage Beneficiaries

Under a contract with the Centers for Medicare & Medicaid Services (CMS), Mathematica’s health experts worked with 24 Medicare Accountable Care Organizations (ACOs) participating in the Shared Savings Program, Next Generation ACO Model, and the Comprehensive ESRD Care Model to identify the strategies that ACOs use to engage beneficiaries in their care. The resulting practices and strategies helped form the Beneficiary Engagement Toolkit, an array of innovative beneficiary engagement strategies that Medicare ACOs use to deliver high quality, effective care. The toolkit includes information on the following strategies:

• Engaging beneficiaries in ACO governance
• Eliciting beneficiary and family feedback
• Supporting beneficiaries in self-care management
• Enhancing beneficiary communication in clinical settings
• Communicating with beneficiaries about the ACO as a value-based care organization

The Beneficiary Engagement Toolkit is the second in a series of resources exploring different aspects of how ACOs provide value-based care. Through this and other toolkits, CMS aims to not only educate the general public about strategies ACOs use to provide value-based care but also present action-oriented ideas to current or prospective ACOs to help them begin or improve operations.

CMS released the Beneficiary Engagement Toolkit on November 25 along with three case studies: 

• Integra Community Care Network’s Approach to Improving Advance Care Planning for High-Risk Beneficiaries
• Southwestern Health Resources Accountable Care Network Three-Day Rule Waiver: Approach to Communication and Implementation
• Silver State Accountable Care Organization’s Provider Engagement Strategy

For more information on these and other resources, including the Care Coordination Toolkit and previously released case studies, please visit the CMS Innovation Center website.

“After the positive reception of the Care Coordination Toolkit released last April, Mathematica is excited to continue to share ACO lessons learned and promising practices with this new toolkit on beneficiary engagement,” said Project Director Kate D’Anello. “We hope that sharing this information with a broader audience will help health care organizations continue to deliver high-value care for their patient populations.”

Mathematica’s health experts are pioneers in advanced health services research, clinical quality improvement and measurement, data quality, analytics, and emerging methodologies—an expertise paired with a strong understanding of health care policy and adoption of technological advancements. Leading with clarifying questions, our close, collaborative approach adapts to evolving policy contexts and moves beyond process to deliver solutions that aim to improve health outcomes, quality, affordability, community well-being, and value.

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