Commercial ACOs May Find Footing Where CMS Slips

Margaret Dick Tocknell, for HealthLeaders Media , August 31, 2011

The commercial ACOs often aren't even called ACOs. They're called alliances, partnerships, affiliations or any number of other names. The Michigan Blues, for instance, calls its program 'organized systems of care.' And these commercial ACOs aren't limited to hospital and physician teams. They are configured to include:

  • Health plans and physicians (Anthem Blue Cross and Individual Practice Association Medical Group of Santa Clara County in the San Francisco area or CIGNA and Piedmont Physicians Group in Atlanta)
  • Health plans and hospitals (Aetna and Carillion Clinic in Roanoke or Humana and Norton Healthcare in Louisville)
  • Physicians and physicians (VISTA Health System and Central Jersey Physician Network in Summit, N.J.)
  • Hospital systems and hospital systems (Methodist Health System and Texas Health Resources in Dallas)

Minnesota's Mayo Clinic may not be interested in the CMS version of accountable care organizations, but it is making moves to strengthen and extend its hospital-physician integration model. In May it signed an agreement with Altru Health System in Grand Forks, N.D. Altru's hospital and clinics now have access to Mayo Clinic physicians, as well as to Mayo's disease management protocols, clinical trials, and clinical care guidelines.

While Mayo isn't slapping the ACO name on this arrangement, it certainly reflects efforts to improve care coordination across multiple systems and to provide better care to patients. Time will tell if this arrangement is cost-effective as well.

A few months ago I spoke with Steve Mansfield, president and CEO of Methodist Health System in Dallas.

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1 comments on "Commercial ACOs May Find Footing Where CMS Slips"

kosos (9/1/2011 at 12:22 PM)
It's interesting to consider how things have evolved since the release of those regulations last April. I think they were a good starting point for even better ideas to develop; they got the conversation started, so to speak. John Nackel gave a nice perspective on some of his ideas for an ACO alternative here: He speaks to the idea that all stakeholders, including patients, need to be equally engaged toward population health. Patients cannot be passive participants in their health care anymore. But are physicians willing to listen?




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