They are formed in order to manage care for a population with the goal of improving outcomes while also lowering costs. Advocate had laid the gauntlet. While the growth of accountable care organizations is inching forward at a national level, it is starting to gain clout in specific markets across the country. Smarter analysis. DRG's comprehensive suite of Market Access solutions help our clients put together the perfect market access strategy. Some of the cookies we use are essential for parts of the website to operate. Market level factors and associations can explain only about 20 to 30 percent of ACO growth, he said. Count on our event-driven analysis to keep you informed and prepared through turbulent market conditions. Interested in LINKING to or REPRINTING this content? While we see changes with the introduction of Advanced Alternative Payment Model, like bundled payments, they also include two of the risk bearing Medicare Shared Savings Program tracks and the Next Generation ACO program, making them a building block for value based care. This increased trend of risk based contracting means that more organizations have skin in the game; If an ACO can’t deliver on the metrics they are bound to, they lose the incentives and risk owing for losses incurred. Although ACOs are not mainstream yet, they are becoming more popular, especially in markets with ACO clustering, like Chicago. "There is still a minority of total lives under risk.". Though ACOs are often described as groups of health care providers, nearly 4 in 10 ACOs partner with a management company for services such as financial investment, contracting, data analytics, and care management, according to recent research. But for ACOs to really gain traction, the key will be to see how successful providers manage populations. Approximately 23 million lives, or 7 percent of the population, are currently covered by about 1,000 ACO contracts, Dr. Muhlestein said. At the heart of this is financial accountability and how providers are participating and being reimbursed. Leverage our expertise to support segmentation and targeting exercises. All Rights Reserved. The structure of an ACO can include Medicare, commercial or Medicaid patients, or any combination thereof, to help facilitate the transition within the US healthcare system to a lower cost, higher value service. Trailblazer organizations like Advocate may choose to launch ACOs because they believe accountable care is a better way of delivering care, Dr. Muhlestein said. Accountable Care Organizations. The failure of the HMO payer-driven model has caused some providers to wait in the wings in regards to ACOs — either for the movement to pass or for it to be tested thoroughly before they put their own organizations at risk. Other influential systems have also been waiting on the sidelines. 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