ACOs May Not Be Right for True Population Health, Researchers Say

Researchers from Weill Cornell Medical College say that in order to ‘formulate effective health care and social service policy’a clear definition of the term ‘population health’ is needed.  Accountable care organizations (ACOs), which they note is a key feature of the Affordable Care Act (ACA), may not clearly have “the incentives or the tools to improve the health of the entire community in which they are located.”

The research, which appears in a recent issue of the Journal of the American Medical Association (JAMA), indicates that few ACOs have the ability to act effectively in the areas of public health, social services and socioeconomic determinants of health. "Population health depends not only on medical care, but also on social services, the public health system and, crucially, on socioeconomic factors, such as housing, education, poverty and nutrition," state the authors in their JAMA article.

“Talking about ACOs as if they are focusing on improving population health -- as opposed to improving medical care for their populations of patients -- leads to a lack of clarity about what ACOs are doing about population health and may divert attention away from social and public health services and from socioeconomic factors critical to health,” they add.

The researchers say ACOs may be better as part of "Accountable Health Communities," working with other organizations to improve geographical population health.  However, lead author, Dr. Douglas Noble, Commonwealth Fund Harkness Fellow in Health Care Policy and Practice in the Department of Public Health at Weill Cornell, says that it “will only be possible to have this debate if the phrase 'population health' is used clearly, and not as a vague way of referring to what ACOs are currently doing.”