A Look At The Evolution Of Health Plan-Provider Accountable Care Partnerships

posted by Courtney Jay

on March 15, 2016

With an evolving health care system comes the need for innovative new ways to deliver and pay for health care. Alternative payment models are an area where health plans are leading the way in delivering better value for consumers.

One model that is helping transform care delivery is the accountable care organization (ACO), which is a group of doctors, hospitals, and other providers that work together to provide coordinated care for patients. Coordination of care is essential for patients managing multiple chronic conditions. A new study by America’s Health Insurance Plans (AHIP), published in The American Journal of Accountable Care (AJAC), found significant progress and expansion in health plan-provider accountable care partnerships, specifically noting improvements in quality of care.

The study built on previous research that examined eight health plans that were early participants in forming ACOs. A look at the evolution of these partnerships over the last four years showed improved performance on clinical quality measures for certain conditions. Diabetes, for example, showed improvements of 19 percent to 25 percent. The study also found reduced rates of emergency department visits (19 percent to 50 percent improvements) and hospital readmission (11 percent to 32 percent improvements).

The progress already underway with ACOs underscores the way innovation and collaboration can lead to better health outcomes for patients. Though more work still needs to be done in advancing delivery and payment system reforms, there has been a demonstrated focus on the part of health plans who in collaboration with providers and other stakeholders continue to emphasize long-term improvements in care, affordability, and accessibility.

To join the discussion on value-based partnerships that are reforming the payment and delivery landscape, register for AHIP’s Institute & Expo, June 15-17, 2016.

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