Accountable care organizations are still in the early stages and struggling to find success. But many payers, including Humana and Atrius Health, are skipping the line by crafting their own ACO models, reports Healthcare Payer News.
One of the main challenges for any ACO is collecting data across the entire healthcare system--and insurers are learning there's not necessarily one correct way to go about it. But that lengthy process of aggregating data from thousands of different hospital systems can help them better understand the costs of their operations, notes Healthcare Payer News.
To address data coordination, many insurers and providers are developing data integration strategies to allow for real-time care coordination and data monitoring, as FierceHealthPayer previously reported.
Payer-led ACOs might do well to take a page out of Humana's playbook. The payer's success lies in its gradual approach to establish slow and steady growth, notes the Healthcare Payer News article. The Louisville, Kentucky-based insurer recognized the need to marry providers' clinical expertise with Humana's business views to drive integrted care, Humana Chief Medical Officer Roy Beveridge, M.D., previously told FierceHealthPayer in an exclusive interview.
Other insurer-led 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.
Healthcare Payer News identified Atrius Health, which launched its own ACO in 2012, as another success story.
The insurer continues to make programs easier to access and focuses on the needs of families and the elderly.
"We also adopted a relatively unique concept in that we wanted to take care of all of our patients exactly the same, no matter what their funding mechanisms were. So we've combined our ACO population with our Medicare Advantage population," CEO Gene Lindsey previously told FierceHealthcare.