Report: California Offers Key Lessons on Rolling Out Successful ACOs
Creating successful accountable care organizations requires more than altering payment procedures and care delivery structures, according to an Integrated Healthcare Association report that examines ACO experiences in California, Modern Healthcare reports (Vesely, Modern Healthcare, 10/26).
ACOs bring together physicians and hospital systems to provide coordinated systems of care. The federal health reform law includes incentives for ACOs that improve health care quality and reduce costs (Becker's Hospital Review, 10/26).
Report Details
For its report, Oakland-based IHA examined five key elements of ACO experiences in California:
- Availability of consumer choice;
- Methods of payment;
- Organizational structure;
- Public policy and regulation; and
- Relationships with health insurers (Modern Healthcare, 10/26).
Key Lessons
The report determined that California's ACO experiences offer 10 lessons for health care providers seeking to pursue such health care delivery structures. The 10 lessons are:
- An organization's capabilities, culture, infrastructure and goals are as important as organizational structure in delivering high quality, coordinated care;
- Aligning incentives between hospitals and physician organizations can offer opportunities for improving performance;
- Payment methods should vary across ACOs, depending on an entity's ability to assume risk;
- Coordinating with health plans on payment methods and performance measurement can play a key role in promoting ACO development;
- ACOs do not represent a comprehensive solution to controlling health care costs;
- ACOs should be equally accessible to residents with different types of public and private health insurance coverage;
- Health care organizations should work to balance patient choice with efforts to curb costs and coordinate care;
- Regulating the financial solvency of health care provider organizations is essential to ensuring market stability;
- Consumer protections should be balanced and not burdensome; and
- Officials should work to establish ACOs in areas that face economic and social challenges (Becker's Hospital Review, 10/26).