PBGH on Accountable Care Organizations
As large purchasers search for strategies to improve the quality and affordability of the healthcare, a growing number are working directly with providers or through their health plans to offer Accountable Care Organizations (ACOs). ACOs have the potential to deliver high-quality care at reduced costs by improving care coordination and linking provider reimbursements to quality outcomes and utilization results.
PBGH offers purchasers guidance on how to select, implement and utilize an ACO program through a comprehensive ACO Toolkit. The Toolkit highlights features that an ACO should provide and support, including:
- A high performance network of providers: ACOs should contain a defined network of providers who have been selected based on their quality, utilization and efficiency.
- Outcomes-oriented measurement: ACOs must be able to produce meaningful evidence of its quality and cost improvements though recognized outcomes and utilization measures.
- Patient-centered and coordinated care: ACOs should support coordinated care and care-planning support with targeted care management for those who need it
- Cost measurement and savings determination: ACOs must be able to to track and reduce overall spending and moderate trend to target CPI or less.
- Transparency: ACOs must be able to be transparent on their spending, savings, cost and quality information and savings distribution.
- Health information technology and administrative infrastructure: ACO should utilize an advanced IT infrastructure that enables it to manage the health of its population.
- Maintaining market competition: ACOs should not use contract exclusivity and/or non- transparency provisions that reduce competition within the market. Rather, ACO development and growth should advance competition among providers in the market.
Many of PBGH’s Members have led the development of ACOs, including CalPERS, Boeing, Intel, and City & County of San Francisco. Our tool kits and guidance are based on the practical experience we have had with large purchasers who are committed to moving the U.S. health system toward integrated, coordinated care delivery models. Read more about how ACOs can raise the bar for health care.
Contact: Emma Hoo, Director, ehoo@pbgh.org
