Value-Based Care

The authors present a brief summary of the types of payment arrangements that early accountable care organizations are adopting.

Jan Berger, MD, MJ, President & CEO, Health Intelligence Partners, and editor-in-chief of The American Journal of Pharmacy Benefits, says the triple aim consists of cost, quality, and access. Additionally, the largest benefit that healthcare consumers can use is their health pharmacy benefit.

First year results are in - all 32 participants in the Pioneer Accountable Care Organization (ACO) initiative showed success in improving quality. However, not as much success was made in cost savings.

In a push for value-based care, UnitedHealth is pledging to double its provider payment in relation to quality and cost efficiency by up to $50 billion within the next 5 years.

Pharmaceuticals companies continue to weigh options for their role in Accountable Care Organizations (ACOs).

Insurer UnitedHealth Group recently noted it will more than double payments made to physicians who participate in accountable care contacts. ACOs have already demonstrated an immense positive growth in quality care, and a reduction in medical costs.

With new models of care delivery, reformation of outdated fee-for-service payment systems, and collaboration of groundbreaking provider-payer partnerships, the changing landscape of the healthcare industry is irrefutable. Yet, the integration of health information technology (HIT) continues to be an area of deliberation for many managed care professionals.

According to Douglas Chaet, Senior Vice President, Independence Blue Cross, incentives for providers in accountable care organizations (ACOs) should stem from wanting to get an edge on the competition.

In January 2012, 32 healthcare organizations became the first to participate in the Medicare Pioneer Accountable Care Organization (ACO) model. Now, over a year into the initiative, as many as 9 organizations are in deliberation of leaving the program.