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Most ACOs are Accountable in Name Only

In his KevinMD blog post , Brian Klepper, Ph.D. voices what many employers fear: that most Accountable Care Organizations are "accountable in name only".

Klepper notes that although there is some movement toward change, few organizations are turning their operations "in a different direction". The culprit? Fee-for-service payment, which results in "business as usual" and provides no real threat to existing health care excesses. As several health system CFOs have said to Klepper "Why should we take less money until we have to?".

Therein lies the answer. Employers and other purchasers need to MAKE the system change by changing the way they pay for care. It is clear, that until we make this fundamental change, business as usual will continue and we will not see the improvements in cost, and maybe not even in quality and safety, that employers and other purchasers want and patients deserve.

But making changes in payment methods, although required, is not sufficient. We must also have information to evaluate whether or not the new payment methods are improving clinical and financial performance. Employers and other purchasers need to demand regular reporting on the total purchaser cost of care (the amount employers and other purchasers actually spend) and the quality and safety of care being provided. Only with information can purchasers determine if their investment in different payment methods is paying off.

As odd as it may sound, employers do not automatically receive this type of information from their health plans and/or the health systems they use. Many Memphis-area employers are already paying differently for care and may not even be aware of that fact (another issue cited by Klepper in his blog post). But none, that I know of, are receiving regular reports on their total cost of care (including any new fees paid under the new payment method) and the quality and safety of care provided in the new model. MBGH is beginning to work with progressive employers to demand this type of information and we are in discussions to get total book of business results for new patient centered medical home models so we can evaluate the financial and clinical performance of these new practice models.

Without regular access to and evaluation of this type of information, Accountable Care Organizations are "accountable in name only".

For more information on MBGH's activities related to collecting and reporting financial and clinical performance for new payment models, contact Cristie Travis at [email protected].

Posted by Cristie Travis at 9:30 PM

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