ACO Serious Illness Care: Survey and Case Studies Depict Current Challenges and Future Opportunities

William K. Bleser
Robert S. Saunders
Lia Winfield
Mark Japinga
Nathan Smith
Brystana G. Kaufman
Hannah L. Crook
David B. Muhlestein
Mark McClellan
Peer-Reviewed Article
June 2019

This resource describes a national survey of ACOs about initiatives to address serious illness, as well as follow-up case studies.

  • Only 8–21 percent of ACOs have widely implemented serious illness initiatives such as advance care planning or home-based palliative care.
  • The authors selected six ACOs with successful programs for case studies and interviewed fifty-three leaders and front-line personnel.
  • Common themes include the need for up-front investment to build serious illness infrastructure and workforce; supporting the business case for organizational buy-in; and how ACO contract specifications affect savings.
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