Accountable Care Organizations – AHA Research Synthesis Report

noncommercial use only. No part of this publication may be reproduced and distributed in any form without permission of the publisher, or in the case of third party materials, the owner of that content, except in the case of brief quotations followed by the above suggested citation. To request permission to reproduce any of these materials, please email [email protected]. Introduction This AHA Research Synthesis Report presents an overview of Accountable Care Organizations (ACOs), including a discussion on the potential impact of ACOs, key questions to consider in developing an ACO, and a review of the key competencies needed to be an effective ACO. This report focuses on the overall concept of ACO yet highlights the specifics of the ACO model proposed in health reform legislation. What are ACOs? The term Accountable Care Organization (ACO) describes the development of partnerships between hospitals and physicians to coordinate and deliver efficient care (Fisher, 2006). The ACO concept envisions multiple providers assuming joint accountability for improving health care quality and slowing the growth of health care costs. The concept was also included in national health care reform legislation as one of several demonstration programs to be administered by Medicare (Patient Protection and Affordable Care Act, 2010). However, ACOs described in health reform legislation are operationally different from other ACO models. The role of ACOs in integrating and aligning provider incentives in care delivery requires participating organizations to posses certain key competencies, as identified in the literature: 3.Relationships with other providers x x x x x x 4.IT infrastructure for population management and care coordination x x x x x x 5.Infrastructure for monitoring, managing, and reporting quality x x x x x x 6.Ability to manage financial risk N/A x x x x x 7.Ability to receive and distribute payments or savings x x x x x x 8.Resources for patient education and support x x N/A x N/A N/A Information on the impact of ACOs is limited and points to key questions that still need to be answered as both the federal and private sectors prepare for widespread implementation of the model. The following are key questions to consider in the development and implementation of ACOs. 1. What are the key competencies required of ACOs? 2. How will ACOs address physician barriers to integration? 3. What are the legal and regulatory barriers to effective ACO implementation? 4. How can ACOs maintain patient satisfaction …