The recently released accountable care organization (ACO) regulations continue to be hotly debated by leading health systems, healthcare associations, and the nation's largest insurers. So it's no surprise that a panel discussion at HCON2011 in Washington, DC, focused on the economics of delivering accountable care.
Matthew Eirich of the Advisory Board Company, a group that studies the healthcare industry, offered three key takeaways for hospitals seeking to develop a sustainable accountable care delivery system.
1. Innovate hospital business models: Accountable care calls on hospitals to rethink payment models and how they contract with health payers. Today, hospitals leverage scale to increase their payment rates. But in the future ACO delivery model, hospitals will need to generate new financial incentives that seek win-win results for both providers and payers.
2. Don't forget clinical model innovation: To create a system of accountable care, hospitals must change the clinical model along with the business model, according to Eirich. That means innovating the hospital's care delivery infrastructure, which includes physician alignment, knowledge management, and facility strategy. For example, consider focusing on how information and costs are shared, not just how much the hospital system is getting paid for them. Invest in standardization techniques, cost reduction, and utilization control.
3. Engage patients: A sustainable accountable care system must also motivate the patients, especially patients with chronic disease or patients who have high risk of utilization, notes Eirich. Hospitals and payers need to work together to get patients actively engaged in their own health, whether through structured benefits or resources put in front of them through the delivery system.