Accountable Care Evolution from 2011-2015: 8 Year-Over-Year Trends
Today's ACOs are larger, busier and better staffed than they were four years ago, according to a year-over-year analysis contained in a new report, 2015 Healthcare Benchmarks: Accountable Care Organizations.
Sea Girt, NJ, July 21, 2015 --(PR.com)-- Adoption of accountable care organizations (ACO) has more than tripled in four years and clinical integration continues to challenge non-adopters, according to a Healthcare Intelligence Network (HIN) analysis of accountable care organization benchmarks from 2011 to 2015.
According to year-over-year ACO metrics published in "2015 Healthcare Benchmarks: Accountable Care Organizations," the healthcare publisher's fourth annual ACO snapshot, the percentage of healthcare organizations in ACOs climbed from 14 to 50 percent in the last four years.
For more information about 2015 Healthcare Benchmarks: Accountable Care Organizations, please visit http://store.hin.com/product.asp?itemid=5055
Leadership of ACOs by payor-provider co-ops or health plans has slowed to a trickle during this period, while the percentage of physician-hospital organization (PHOs) firmly grasping administration reins has nearly doubled—from 15 percent in 2011 to 28 percent among 2015 respondents.
ACO Staffs Support Healthcare Integration
The ACO staff has become more diverse, boasting more specialists, health coaches and clinical psychologists to support integration of behavioral health and primary care, the "sweet spot" of patient-centered medicine, noted Melanie Matthews, HIN executive vice president and chief operating officer.
"Our 2015 respondents who shared ACO success stories consistently mentioned impacts from care coordination and care management," said Ms. Matthews.
Staffing within ACOs has swelled as well: 29 percent of 2015 survey respondents support 500-1,000 physicians within its ACO, nearly double the 17 percent reporting this staffing ratio in 2011.
The average ACO is also busier than ever, with 61 percent encompassing 10,000 covered lives or more, up from 42 percent in 2011, perhaps reflecting consolidation occurring across the healthcare landscape.
Today, healthcare organizations are more conservative about time required to adequately frame an ACO, with 20 percent of 2015 respondents reporting that two years or more was needed, up from 4 percent in 2011, while the percentage requiring 12 to 18 months for ACO creation dropped from 50 percent in 2011 to 37 percent this year.
Reimbursement Shift from Volume- to Value-Based
The retrospective data supports the industry's transition from the traditional fee for service (FFS) payment environment to the value-based reimbursement structure favored today, with 45 percent of 2015 respondents favoring a FFS + care coordination + shared savings payment model, up from 15 percent in 2012. (Note: 2011 respondents were not surveyed on reimbursement models).
This handwriting is on CMS’s wall, in the form of its pledge to move half of Medicare payments into value-based payment models by 2018. More than half of 2015 respondents—54 percent—expressed faith in the federal payor's ability to meet this financial goal.
Despite the latest benchmarks, operational ACOs insist no two accountable care organizations are alike. In the experience of Steward Health Care Network, a top-performing Medicare Pioneer ACO,
“When you’ve seen one ACO, you've really seen... one ACO.” Having ended Pioneer performance year two with gross savings of $19.2 million, Steward still must scale the perennial hurdles of physician engagement, performance improvement and care management, noted Kelly Clements, Steward’s Pioneer program director, during a recent HIN program on Care Management, Quality Improvement and Data Integration in Steward's Medicare Pioneer ACO.
This year’s ACO survey benchmarks bear this out. Clinical integration, which can only succeed with the support of an engaged physician population, is still the biggest barrier to ACO formation, say 17 percent of 2015 survey respondents with no plans for accountable care.
For more information about 2015 Healthcare Benchmarks: Accountable Care Organizations, please visit http://store.hin.com/product.asp?itemid=5055
About the Healthcare Intelligence Network — HIN is the premier advisory service for executives seeking high-quality strategic information on the business of healthcare. For more information, contact the Healthcare Intelligence Network, PO Box 1442, Wall Township, NJ 07719-1442, (888) 446-3530, fax (732) 449-4463, e-mail info@hin.com, or visit http://www.hin.com.
According to year-over-year ACO metrics published in "2015 Healthcare Benchmarks: Accountable Care Organizations," the healthcare publisher's fourth annual ACO snapshot, the percentage of healthcare organizations in ACOs climbed from 14 to 50 percent in the last four years.
For more information about 2015 Healthcare Benchmarks: Accountable Care Organizations, please visit http://store.hin.com/product.asp?itemid=5055
Leadership of ACOs by payor-provider co-ops or health plans has slowed to a trickle during this period, while the percentage of physician-hospital organization (PHOs) firmly grasping administration reins has nearly doubled—from 15 percent in 2011 to 28 percent among 2015 respondents.
ACO Staffs Support Healthcare Integration
The ACO staff has become more diverse, boasting more specialists, health coaches and clinical psychologists to support integration of behavioral health and primary care, the "sweet spot" of patient-centered medicine, noted Melanie Matthews, HIN executive vice president and chief operating officer.
"Our 2015 respondents who shared ACO success stories consistently mentioned impacts from care coordination and care management," said Ms. Matthews.
Staffing within ACOs has swelled as well: 29 percent of 2015 survey respondents support 500-1,000 physicians within its ACO, nearly double the 17 percent reporting this staffing ratio in 2011.
The average ACO is also busier than ever, with 61 percent encompassing 10,000 covered lives or more, up from 42 percent in 2011, perhaps reflecting consolidation occurring across the healthcare landscape.
Today, healthcare organizations are more conservative about time required to adequately frame an ACO, with 20 percent of 2015 respondents reporting that two years or more was needed, up from 4 percent in 2011, while the percentage requiring 12 to 18 months for ACO creation dropped from 50 percent in 2011 to 37 percent this year.
Reimbursement Shift from Volume- to Value-Based
The retrospective data supports the industry's transition from the traditional fee for service (FFS) payment environment to the value-based reimbursement structure favored today, with 45 percent of 2015 respondents favoring a FFS + care coordination + shared savings payment model, up from 15 percent in 2012. (Note: 2011 respondents were not surveyed on reimbursement models).
This handwriting is on CMS’s wall, in the form of its pledge to move half of Medicare payments into value-based payment models by 2018. More than half of 2015 respondents—54 percent—expressed faith in the federal payor's ability to meet this financial goal.
Despite the latest benchmarks, operational ACOs insist no two accountable care organizations are alike. In the experience of Steward Health Care Network, a top-performing Medicare Pioneer ACO,
“When you’ve seen one ACO, you've really seen... one ACO.” Having ended Pioneer performance year two with gross savings of $19.2 million, Steward still must scale the perennial hurdles of physician engagement, performance improvement and care management, noted Kelly Clements, Steward’s Pioneer program director, during a recent HIN program on Care Management, Quality Improvement and Data Integration in Steward's Medicare Pioneer ACO.
This year’s ACO survey benchmarks bear this out. Clinical integration, which can only succeed with the support of an engaged physician population, is still the biggest barrier to ACO formation, say 17 percent of 2015 survey respondents with no plans for accountable care.
For more information about 2015 Healthcare Benchmarks: Accountable Care Organizations, please visit http://store.hin.com/product.asp?itemid=5055
About the Healthcare Intelligence Network — HIN is the premier advisory service for executives seeking high-quality strategic information on the business of healthcare. For more information, contact the Healthcare Intelligence Network, PO Box 1442, Wall Township, NJ 07719-1442, (888) 446-3530, fax (732) 449-4463, e-mail info@hin.com, or visit http://www.hin.com.
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Healthcare Intelligence Network
Patricia Donovan
732-449-4468
www.hin.com
https://twitter.com/H_I_N
Patricia Donovan
732-449-4468
www.hin.com
https://twitter.com/H_I_N
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