A Model for Value-Based Provider/Payer Partnerships
With the recent spotlight on accountable care, health plan and provider organizations are seeing an opportunity to collaborate to drive down the medical cost trend and increase their commercial market share through lower premiums. Providers are creating integrated health care partnerships with health plan organizations to align financial incentives, focus on improving outcomes and reduce redundancies. In an eight-month period between 2011 and 2012, the market saw a 38 percent increase in ACOs with hospitals, health plans and physician groups.1 And 43 percent of organizations that are or plan to be part of an ACO will utilize a commercial shared savings model rather than a Medicare ACO or Medicare Shared Savings model.2
Forward-thinking organizations can develop a strategic approach to accountable care by identifying unique partnerships. According to a 2012 Optum study,3 hospitals and physician groups are the most likely ACO partners, but other organizations, including health plans, skilled nursing facilities and long-term care facilities, are becoming involved as well.
- David Muhlestein et al. Growth and Dispersion of ACOs: June 2012 Update (Salt Lake City: Leavitt Partners, 2012), 9.
- Margaret Dick Tocknell. The Unsettled State of the ACO (Brentwood, TN: HealthLeaders Media, 2012), 10.
- Multistakeholder Survey, Optum Institute-Harris Interactive. Optum Institute for Sustainable Health, July 2012.