Calif. Partnership Says it Has Achieved Goals of Federal ACO Efforts
A private-sector partnership between California health care organizations says it already has achieved the care coordination and cost-reduction goals that federal officials are pursuing as they encourage health care providers to form accountable care organizations, The Hill reports.
Background on ACOs
Earlier this year, federal officials unveiled proposed rules governing the creation of ACOs under the federal health reform law (Pecquet, The Hill, 6/26).
ACOs aim to lower costs and improve care by fostering cooperation between physicians, hospitals and other health care providers. The overhaul requires federal health programs to begin contracting with ACOs starting in January 2012 (California Healthline, 4/13).
In 2007, Blue Shield of California, Catholic Healthcare West and Hill Physicians Medical Group formed a partnership in response to concerns about rising health care costs andÂ their effect on policyholders. The partners said they reduced costs by eliminating duplicative positions and jointly funding new positions to make care more efficient.
The group did not form in response to legislation or licensing requirements. In addition, the participating organizations said it did not require a significant amount of capital to start their partnership.
Results of Partnership
Four years after its creation, the partnership said it prevented premiums from rising for 41,500 CalPERS members between 2009 and 2010 (McCarthy, National Journal, 6/26). The group also said the partnership helped reduce CalPERS' health care spending by $15.5 million in 2010 (The Hill, 6/26).
In addition, the partnership said it has helped reduce the average length of hospital stays by 15%, curb readmissions and deliver better care.
Implications for Federal ACO Efforts
Despite its involvement with the California partnership, Catholic Healthcare West says it does not intend to participate in the federal government's ACO efforts (National Journal, 6/26).
Wade Rose, vice president of external and government relations for CHW, said the federal government's proposed ACO rule "sets the bar too high and creates incentives too low. So you really have to question whether it's worth it, especially in relationship to what we're already accomplishing."
Participants in the California partnership also have criticized a provision of the proposed ACO rule that would prevent health care providers from knowing upfront which Medicare beneficiaries are enrolled in the ACO. Health care providers say they need to know whether they are financially responsible for certain health outcomes (The Hill, 6/26).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.