How ACOs Are Slowing Healthcare Costs

Jacqueline Fellows, for HealthLeaders Media , December 12, 2012

"This is happening in Massachusetts with Blue Cross Blue Shield. We've also seen the state of Michigan, the Blue Cross plan there has started to really think of paying for... higher increases if there's a return in better outcomes and higher quality care."

In another sign that ACOs are catching onto the private insurers, look no further than Florida. There, just yesterday, it was announced the state's Blue Cross Blue Shield Company will partner with Naples, FL-based NCH Healthcare System for what is being called one of the first commercial ACOs in the state. Under the new Florida Blue ACO, about 4 million patients will get to participate.

An earlier 2012 report from Oliver Wyman estimated as many as 15 million patients in the commercial market are already receiving care through an ACO that was initially established under Medicare.

The consulting firm's analysis argued that organizations using an ACO to serve Medicare patients will eventually have to roll the model out to its non-Medicare population because "virtually any provider that moves to a value-based contract with its most significant payer—Medicare—will  eventually need to move all of its patients to value."

Schoen concurs, saying using a value-based model for just one segment of the healthcare population doesn't make sense. "We all get care locally and we need to be thinking about more accountable care systems as well as more accountable health insurance companies," says Schoen. "We need the various payers to be on the same page in the marketplace."

Jacqueline Fellows is an editor for HealthLeaders Media.
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2 comments on "How ACOs Are Slowing Healthcare Costs"

Todd (12/14/2012 at 5:11 PM)
We do not all get care locally. People travel overseas for surgery all the time and more will do so in the future.

Jim (12/13/2012 at 10:04 AM)
La-La land at the Commonwealth Fund. Where is the proof? I've spent 44 years working in health insurance - there are pricing variations from year to year, and what we saw in 2012 were price increases that reflect an over-reaction of insurance pricing decisions made in the prior 3 years. Take a look at the pricing reactions for renewals in the first quarter of 2013 - those are proof that PPACA is working.




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