Last year, all of healthcare was abuzz over accountable care organizations (ACOs). This year, the new fad seems to be tearing the concept apart before it even has a chance to develop.
But criticisms of accountable care hinge on a false premise – that the only way to become accountable for care is to contract for shared savings with the Centers for Medicare & Medicaid Services (CMS). The reality is that there are many markets for providers to evaluate as they begin the journey toward more coordinated, accountable care, and a variety of partnerships and strategies that can be deployed to get there.
Based on our assessments of "ACO readiness" in 90 markets, it is clear there are at least six additional populations to target beyond Medicare.
1. Your own employee health plan. The first place to look is in the mirror. Most health systems and large hospitals are self-insured, providing an opportunity to experiment with insured employees. This provides a "learning laboratory" that will help minimize risk when assuming accountability for additional populations.
Like other employers, health systems are already using incentives to promote healthy behavior among employees, like losing weight. Some health systems such as the Cleveland Clinic are no longer hiring smokers. They are also encouraging employees with chronic illness to enroll in disease management programs and designing benefits to reward employees for taking cost-saving measures, such as using generic drugs.