Perspectives on State Government–Sponsored Accountable Care for Public Employees
Objectives:
Most studies of accountable care organizations (ACOs) have
focused on contracts with commercial payers, Medicare, or Medicaid. This
study contributes to the literature by describing implementation of an ACO
for public employees, contracted by a state government under a federally
funded State Innovation Model grant.
Results:
Interview participants discussed conditions for ACO adoption,
components of implementation, likely effectiveness, and expectations
about sustainability. The state government influenced ACO development
by creating opportunities for innovation in care delivery, leveraging
purchasing power, providing data, developing and maintaining strategic
contracts, and encouraging public employees to enroll in accountable care
plans. In some organizations, the ACO may have had a spillover effect,
improving care for patients who were not public employees. Findings
indicate that this state-led ACO shared traits with other public ACOs
contracted under Medicare and Medicaid.
Conclusions:
By implementing an ACO for public employees, state
governments may catalyze improvements in health care and influence the
direction of payment reform.
