Markets, Metrics, Maturity and ACO Model: 6 Market Types

By Joseph F. Damore and Barbara Gray

As finance leaders consider whether to apply to the Medicare Shared Savings Program, they should evaluate the application of accountable care principles to six other markets for value-based contracting.

When the Centers for Medicare & Medicaid Services issued proposed regulations for Medicare accountable care organizations (ACOs), it refocused attention on the need to improve population health while slowing cost growth.

But as hospitals develop plans for accountable care, they would be wise to consider additional market segments. After all, the need for higher value health care doesn’t start and end with Medicare. You can find accountable care principles at play in many places as providers and payers drive toward new, value-driven models of care in lieu of traditional fee-for-service. These providers are meeting quality metrics, implementing improved care processes (such as transitions of care and patient activation), assuming risk, forming partnerships with payers and other providers, offering incentives for population health and wellness, and deploying health IT.

Six Markets Beyond Medicare

Based on our work assessing “ACO readiness” in nearly 90 markets, it is clear that there are at least six additional partners or populations to target beyond Medicare.

Your own employee health plan. The first place to look is….

To read the complete ‘Building Accountable Care, Block by Block’ article, click here.


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