Accountable Care Organizations Key to Value-Based Care

In an era of “heavy-duty strategies and tough decisions,” one healthcare expert urged providers to consider the accountable care organization (ACO) as part of their future. In particular, JD Whitlock, director of clinical and business intelligence at Catholic Health Partners, recently said that ACOs are critical for organizations that seek to achieve truly value-based care.

“We’ve seen the promised land of value-based care,” Mr Whitlock said, “and we’re trying to get there, but right now we’re tumbling down the mountain of fee-for-service.”

Current providers who are considering the benefits of accountable care should look no further than organizations that are already achieving success. This includes companies such as Geisinger, the Mayo Clinic, and Kaiser. He said these health leaders have effectively adopted aspects of the accountable care model, including effective management of electronic health records. These organizations’ pioneering efforts demonstrate that newcomers have little reason to worry about issues such as interoperability within an ACO.

Mr Whitlock added that with strong business intelligence, any organization can handle the challenges they may face when becoming an ACO. He cited an article in The American Journal of Accountable Care (AJAC), which offered 8 required “habits” of US health systems. Some habits that organizations may consider include: public health practice, interprofessional team care management, and physician compensation design.

“The next transformation is to accountable care, and while definitions may differ, the foundation of the ACO is its ability to assume the responsibility for the health of attributed populations, over time, for known allocations of funding (financial risk transfer),” wrote author Daniel K. Zismer, PhD, Wegmiller Professor and Director, MHA and Executive Studies Programs, University of Minnesota. “With this transformation, the business relationship between provider and payer changes fundamentally, as do related financial incentives. Systems of healthcare delivery are transformed from manufacturers of units of service sold to sick people on a per unit basis to systems of healthcare accountable for the health status of a population and all related current and future health services needed. This includes provision of preventive healthcare and care for the acutely ill. The principal difference in the financial model is the nature of the incentives: ‘more is better’ shifts to ‘more is more costly to the provider.’”

AJAC is a publication produced by The American Journal of Managed Care (AJMC). AJMC hosted its first ACO and Emerging Health Delivery Coalition event on May 15-16, 2014, in Baltimore, Maryland. This group includes more than 60 ACOs, insurance companies, integrated delivery networks, pharmaceutical companies, and other organizations that are focused on sharing insights about the opportunities that exist with implementing accountable care models. More information about the coalition is listed on AJMC’s website at http://www.ajmc.com/acocoalition.

Around the Web

Value-Based Care Relies on ACOs Making It, Expert Says [Government HealthIT]

Accountable Care Organizations Facing New Competency Challenges: The “8 Habits” Required of US Health Systems [AJMC]