Accountable Care Organizations (ACOs): shaping the future of health care

The ACO concept is still evolving. At present, an ACO is defined as a collaborative organization that cares for a defined population of health care needs and agrees to be held accountable for attaining measurable quality improvements and meeting cost targets. While provider payment models may vary, they all contain incentives to improve quality and efficiency.

In the best case scenario, payers, providers, hospitals, and patients alike thrive as a result of higher quality outcomes and lowered costs. The entire health care system is connected and collaborative—reducing unnecessary tests, adverse drug reactions, and common errors.

The recent release by CMS of the proposed rule on Medicare payments to providers participating in ACOs is an important step in the modernization of the health care system. But, these new ACO guidelines do not go far enough to fix an unsustainable health system. ACOs, as guided by the Patient Protection and Affordable Care Act, will be built on a regulatory framework—attractive to some, prohibitive to others.

Collaboration

Creating collaborative care models has been our short- and long-term strategy. Real-world experience with market-led models enables our experts to provide viewpoints and solutions that anticipate significant issues that threaten the scalability and long-term sustainability of ACOs.

We believe that the present ACO model is limited. We support a comprehensive approach to achieve truly effective and cost-efficient health, and a health system that works better for everyone. Because we work with people throughout the entire health system, we use our ability and scale to help our clients envision and implement new approaches that drive positive change,  optimize care quality, lower costs, and enhance satisfaction.

Connection and alignment

Health information technology is being used on a wide scale today as the underpinning to collaborative care. To help communities apply actionable information at the point of decision-making, we offer data exchange to supports HIEs and RHIOs, and physician-led initiatives to improve systems, become more cost-efficient, and deliver better quality care.