Dr Suzanne Delbanco on Employers and ACO Arrangements

Suzanne Delbanco, PhD, MPH, executive director of Catalyst for Payment Reform, explains how her organization is helping employers better understand accountable care organizations (ACOs) and judge how the ACO model might work with their population.

Transcript

Catalyst for Payment Reform recently tried to measure the prevalence of ACOs. What did you find and what challenges did you run into?

For a project that we have called, Scorecard 2.0, where we’re trying to measure how much payment reform there is, what type, and what changes that’s lead to in the healthcare system. We wanted to measure the prevalence of ACOs, and we found that it was virtually impossible to do. We consulted all the leading experts in the country who have been trying to do this, because there’s not one definition of an ACO. So, even when we tried to come up with ideas to test providers who come together with responsibility for a given population of patients supported by an alternative payment model, there were challenges to that definition. Unfortunately, for now, we haven’t found a very good way to track ACOS.

Catalyst for Payment Reform also created a toolkit for employers on ACO arrangements. What does the toolkit include and how can employers use it?

Employers were feeling frustrated by the lack of transparency that they had into their health plan’s ACO arrangements. Health plans are touting how many ACO contracts they have and sharing some results, but they felt cherry picked and not comprehensive or as meaningful as employers wanted those results to be. They want to make decisions whether or not they should back this approach and seek it proactively for their population members.

So, we pulled employers together who were feeling this frustration and worked over a year to come up with the kinds of information they would want to know from their health plans, and then, we turned that into a standard template report that employers can ask their health plans to use in sharing results of their ACO arrangements. The hope is that employers will be able to better judge how effective this movement is, work with the health plan on ACOs that are not so effective to try to help it improve, or maybe move on to something else, and ultimately have a better understanding of how well the ACO model might work for their population over time.