Earlier this year, The Centers for Medicare and Medicaid Services announced some 450 participants in its bundled payment program, one of many flavors of accountable care. The bundled payment model aims at improving outcomes and reducing costs for a select group of procedures and related services.
If nothing else, the announcement gave a shot in the arm to the accountable care movement, offering a concrete example of just how broad the shift away from fee-for-service to fee-for-value is. "It's the largest voluntary Medicare accountable care model," notes Rob Lazerow, a senior consultant at the Advisory Board Company. "It has nearly twice as many provider organizations compared to those participating in the shared savings program. It represents a big spike in experimentation."
To Lazerow, 2013 is emerging as the year of accountable care. He notes that in addition to the Medicare efforts, a large number of commercial health plans are forging partnerships with providers with the same goals.
Although falling under the ACO framework, which reimburses based on outcomes, not productivity, these arrangements are widely varied, he says. "Some are contractual or incentive models; some are joint ventures," he says. "We are starting to see many partnerships, with payers and providers coming together."
Regardless of the model in play, the I.T. challenges are many, as data capture, sharing and analytics form the cornerstone of reimbursement reform. Gary Baldwin’s cover story in the April issue of Health Data Management takes a detailed look at three ACOs currently under way with both commercial and public payers.
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