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Hospital participation in accountable care organizations (ACOs) is projected to double in 2014, according to Premier, Inc.'s fall 2013 Economic Outlook C-suite survey.
More than 18 percent of 115 senior executive respondents - primarily CEOs (43.5 percent), chief financial officers and chief operating officers - across 35 states say their hospitals currently participate in an ACO, up from 4.8 percent in spring 2012. This growth is projected to accelerate, with about 50 percent of respondents suggesting their hospitals will participate in an ACO by the end of 2014. Overall, 76.5 percent of respondents say their hospital does or will participate in an ACO.
The pace of adoption has been slower than originally anticipated by senior executives surveyed 18 months ago. Though 51.8 percent of executives predicted in the spring of 2012 that their systems would create or join an ACO by the end of 2013, results show that only 23.5 percent will likely meet that projection.
"The ACO transition is challenging for all providers, and it involves taking significant risks," said Wes Champion, senior vice president, Premier Performance Partners. "It's understandable and appropriate that some providers have been more deliberate and cautious about when they participate in an ACO. And it's clear that many are now prepared to proceed."
Survey results also suggest:
Population health management partnerships, investments
According to survey results, the majority of health systems are developing partnerships and making investments in the infrastructure necessary to better manage population health.
Respondents cited partnerships with internal physicians and provider leadership most often. Partnerships with large local employers are also popular across all types of providers (51 percent).
"Coordinating care and delivering more efficient care has been a passion at Aurora for years," said Richard Klein, executive vice president, Enterprise Business Group, Aurora Health Care (Milwaukee, Wis.), a 15-hospital system serving more than 1.2 million annually throughout eastern Wisconsin and northern Illinois. "As a self-insured employer, we've been diligently working on this with our own employees for 15 years. Now, we've built an organization that is integrated, highly efficient and is able to produce a better result for the patient."
Data, data, data
Access to integrated data with sophisticated population health status measurement is important to ACO formation. According to respondents:
"Within our organization, clinical teams will always serve as the 'backbone' to the challenging work around population health," said Michael P. Jeremiah, MD, FAAFP, chair of the Department of Family and Community Medicine at Carilion Clinic (Roanoke, Va.), which cares for nearly 1 million residents across 18 counties in western Virginia through its eight hospitals, primary and specialty physician practices, and other services. "But IT and health analytics provide the 'nervous system' that allow us to fully function and achieve optimal patient experiences and outcomes while controlling cost."
Payer partnerships and arrangements
Survey respondents are exploring new population health partnerships with private (46.2 percent) and public (40.4 percent) payers. Among these partnerships, upside-only shared savings was the most often cited arrangement (58 percent). In this model, key care management programs are established to manage high-risk and chronically ill populations using claims analytics to predict outcomes. Savings that accrue are split equally between insurers and providers, with no penalties for failure to achieve the goals.
"Providers are building the infrastructure and core capabilities essential to ACO formation, whether or not they're in an ACO," Champion said. "This implies a new wave of ACO participants will likely emerge in future years as these partnerships mature."
Article adapted by Medical News Today from original press release. Source:
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