Accountable care organizations (ACOs) are still a new creature in the world of managed care, and not all are alike. As the authors of a new comparative analysis in The American Journal of Managed Care outline, Medicare contracts dominate the ACO landscape, with only half of these entities having a contract with a private payer.
AJMC Takes an Early Glimpse Into ACO Contracts
FOR IMMEDIATE RELEASEDecember 22, 2014
PLAINSBORO, N.J.—Less than a decade after healthcare’s first experiments with “accountable care organizations,” the ACO has gained a foothold through its inclusion in the Affordable Care Act (ACA). Yet not all ACOs are created equal, as the authors of a new article in The American Journal of Managed Care showed in a comparative analysis published this month. A full copy of the analysis can be found here.
Led by Valerie A. Lewis, PhD, this analysis used data from the National Survey of Accountable Care Organizations, and included ACOs that had been established by August 2012—and had information that was publicly available. “Our data provide the first comprehensive, systematic picture of the commercial ACO contract landscape,” the authors note. “Our results illuminate how commercial ACO contracts compare with public ACO contracts, as well as what types of provider organizations are pursuing each type of contract.”
Among the findings:
Commercial contracts with more complex risk features and upfront payments are still less common, but where they exist, these arrangements are more sophisticated and collaborative. Private ACO contracts were more likely to have these features (compared with public contracts):
Organizations with private ACO contracts were more likely to have experience with pay-for-performance plans, such as patient centered medical homes, public reporting, and risk-based contracting. These entities also employed more full-time physicians.
About the Journals
The American Journal of Managed Care, now in its 20th year of publication, is the leading peer-reviewed journal dedicated to issues in managed care. The American Journal of Pharmacy Benefits, provides pharmacy and formulary decision-makers with information to improve the efficiency and health outcomes in managing pharmaceutical care. In December 2013, AJMC introduced The American Journal of Accountable Care, which publishes research and commentary devoted to understanding changes to the healthcare system due to the 2010 Affordable Care Act. AJMC’s news publications, the Evidence-Based series, bring together stakeholder views from payers, providers, policymakers and pharmaceutical leaders in oncology and diabetes management. To order reprints of articles appearing in AJMC publications, please call (609) 716-7777, x 131.
CONTACT: Mary Caffrey (609) 716-7777 x 144
Public Hospitals More Likely to Extend Unprofitable Services After 340B Participation, Study Finds
May 10th 2024Public hospitals were significantly more likely to sustain access to unprofitable services following 340B Drug Pricing Program participation, while nonprofit hospitals were mostly unaffected, according to a recent study.
Read More
Frameworks for Advancing Health Equity: Urban Health Outreach
May 9th 2024In the series debut episode of "Frameworks for Advancing Health Equity," Mary Sligh, CRNP, and Chelsea Chappars, of Allegheny Health Network, explain how the Urban Health Outreach program aims to improve health equity for individuals experiencing homelessness.
Listen
Research Shows Prior Authorization Denials Delay Critical Immunology Care
May 10th 2024Results featured at the Academy of Managed Care Pharmacy 2024 annual meeting revealed a pattern of prior authorization rejections that could delay necessary therapeutic treatments for various patient groups.
Read More
CMS Medicare Final Rule: Advancing Benefits, Competition, and Consumer Protection
May 7th 2024On this episode of Managed Care Cast, we're talking with Karen Iapoce, senior director of government products and programs at ZeOmega, about the recent CMS final rule on Medicare Part D and Medicare Advantage.
Listen
Looking Back on ISPOR 2024: Hot Policy Topics, Welcome Focus on Employers, and More
May 10th 2024Kimberly Westrich, MA, chief strategy officer of the National Pharmaceutical Council, reflects on the most valuable learnings from the 2024 meeting of ISPOR—The Professional Society for Health Economics and Outcomes Research, including lively discussions of the Inflation Reduction Act and workshops on value assessment.
Read More