Almost every insurer, big and small, has launched an accountable care organization in the last few years. As they become more prevalent, ACOs will likely help transform the healthcare industry, altering provider payments and introducing new care models.
But there also are inevitable bumps that insurers will face along the road as ACOs mature. Based on insurers' experience and ACOs' success so far, stakeholders shared lessons learned during a National Health Policy Institute roundtable, as reported in a Health Affairs blog.
Transitioning to targeted solutions: Global budgets commonly found in ACOs let providers focus on value instead of volume when caring for patients. That means insurers are investing in new care services for prevention and wellness, chronic disease management, and behavioral and mental health. In many cases, doctors are leading the innovations by redesigning how care is delivered, including creating new clinical protocols, developing ways to track patient outcomes, measuring cost savings and leveraging other practitioners as part of the care team.
Emerging technologies: Along with the rise of ACOs, new technologies to help engage patients have grown as well. These technologies can actually be cost effective given the total medical expenses for each patient because they can help prevent expensive hospital and emergency room admissions. Moreover, according to representatives from several healthcare organizations during a panel discussion at the fourth annual Health Datapalooza conference in Washington, D.C. last month, patient engagement technology that prompts more preventtive behavior and spurs discussions beteen providers and patients will be crucial to ACO success.
Evidence-based care: To help ensure providers offer the best evidence-based medicine, some ACOs are creating committees and review boards to analyze evidence, including safety, effectiveness, patient-centeredness and cost-effectiveness, to decide whether new care protocols should be used. For example, Pioneer ACO Steward Health Care System decreased the use of anesthetic agents after reviewing evidence that showed that one type of agent was four times more expensive than the others, noted Health Affairs.
To learn more:
- here's the Health Affairs blog