I think this is my very first post referencing the Accountable Care Organization (ACO) concept, I am behind the times. If you are new to it as well, this policy brief will help you.
There is also a helpful pair of blog posts on the Health Affairs blog that argue whether ACO’s will solve problems in our health care system today. Even though they show two different sides of the issue, I enjoyed the fact that both pointed out the role of patient involvement.
Rationalizing how care is provided will not work without patient cooperation. Rather, patients should be given rich comparative cost and value information. They should also be given the powerful incentive of reduced cost sharing and the opportunity to forgo costly Medigap coverage if they choose to receive care in an ACO. It is vital that both local health systems and patients consent to participate in sharing risk.
While ACOs place an emphasis on provider incentives, we would like to see ACO pilots extend to the consumer side of the medical marketplace to better engage patients in their own decisions about health and health care. This can take a number of forms. In the short term, consumers can get reliable and timely information to help them make better health care decisions. But it could also include more active steps like sharing a portion of savings with consumers when they participate in systems that are delivering high-quality, cost-effective care. This latter example could be similar to “Centers of Excellence” programs that pass a portion of savings on to consumers in the form of lower premiums or to tiered provider networks that give patients lower copayments when they choose high-quality, cost-effective providers. But such consumer incentives are not an ACO requirement.
Both blog posts are worth reading in their entirety; these passages are a great variation on the theme expressed in this tweet, great to see it manifested in the discussions of today.