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Early ACO results: First steps prove challenging

by Diana Bradley, Staff Writer | August 08, 2013
Experts from a diverse group of health systems referenced a white paper analysis during a webinar on Tuesday. They cited some of the first examples of quality cost, patient experience and utilization improvements among the nation's earliest accountable care organizations (ACOs) and the challenges that came along.

Joe Damore, vice president of population health at Premier Research Institute, which supported the paper along with the Commonwealth Fund, said the best way to help people better understand the challenges, barriers, motivations, strategies and best practices was to hear directly from the organizations implementing them. In this case: Fairview Health Services of Minneapolis, Minn.; Memorial Healthcare System of Hollywood, Fla.; Presbyterian Healthcare Services of Albuquerque, N.M.; and AtlantiCare of Egg Harbor Township, N.J.

"[The Premier Research Institute] has had the pleasure to work in over 120 communities across the country and learn from many organizations," said Damore. "...The paper really focuses on what this journey is all about and what we are learning in this journey."

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The Premier Research Institute conducted on-site interviews in October and November 2011 with executive leaders and applied Premier's Population Health Capabilities Framework to inventory the building blocks needed to transform delivery from volume-based to value-based health care.

At the time of analysis, two of the four organizations were engaged in ACO contracts with commercial payers; three of the four were working with their own self-insured employee plan; and Fairview and Presbyterian Healthcare Services were participating in the Medicare Pioneer program. Currently, all four organizations are engaged in ACO contracts with state or federal governmental agencies (Medicare Advantage, Medicare Pioneer, Shared Savings Program or Bundled Payment for Care Improvement, or state Medicaid programs).

Individual successes
Each of the four organizations showed significant improvements in quality and reductions in cost and utilization, according to the paper.

From 2009-2011, Fairview Health Services outpaced the market in improving optimal vascular care from 35.1-48.9 percent, and patient experience scores with 88.1 percent of patients saying they would recommend Fairview clinics. Further, inpatient utilization also dropped by 13.7 percent comparing 2010 to 2011 hospital volumes.

Meanwhile, the Florida State Health Department was spared $20 million by the Memorial Healthcare System, which coordinated care for 4,000 special needs children over three years.

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