Accountable care organizations (ACOs) that have been popping up throughout the private healthcare industry are offering new and successful healthcare delivery and payment models, according to a new study by America's Health Insurance Plans (AHIP) published in the journal Health Affairs.
Preliminary data from the eight health plans studied demonstrate that ACOs have effectively improved the quality of patient care while also lowering costs. In fact, the health plans studied "reported approximately 10 percent improvements in quality, a 15 percent decrease in readmissions and total patient days in a hospital, as well as annual savings of $336 per patient," notes AHIP.
The AHIP study found that providers have different levels of experience, capability, and readiness to enter into ACOs. Health plans in successful ACOs meet their provider partners' abilities and needs, evaluating their ACO readiness based on their level of clinical integration, presence of forward-thinking leadership, willingness to enter into a long-term relationship, ability to initiate and implement change, existence of strong health IT infrastructure, sufficient patient size, willingness to participate in performance-based reimbursement models, and ability to accept some form of financial risk.
Another key aspect of a successful ACO is the health plan's technical assistance for providers. For example, health plans can support providers by assisting with population health management, providing access to health information exchange systems with two-way information flow, and helping to manage financial risk through predictive modeling and the provision of stop-loss coverage or reinsurance.
To learn more:
- read the Health Affairs article abstract
- check out the AHIP blog
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