While the concurrent implementation and ongoing attempts to repeal the Patient Protection and Affordable Care Act (ie Obamacare) dominate headlines, 2 independent yet closely related storylines drive the national dialogue. The most prominent is the healthcare providers’ pursuit of the “triple aim,”1 which includes enhancing the care experience, improving population health, and reducing healthcare expenditures. Equally important is the changing face of the healthcare consumer as access to care grows, demographics change, and engagement increases. In this time of contention, there seems to be a growing consensus among stakeholders that the traditional, volume-based, fee-for-service (FFS) care is an untenable strategy to deliver evidence-based care that is both fiscally sustainable and able to meet the clinical needs of Americans. As we look for a solution to an overspending, underachieving system, the concept of “accountable care” has received much attention as a potential mechanism to better align provider financial incentives with high-quality care.
In light of these national trends and in response to multistakeholder
interest, The American Journal of Managed Care is pleased to launch The American Journal of Accountable Care. The content in this inaugural and future issues aims to highlight the opportunities and challenges faced by providers, payers, and patients as delivery systems, payment models, and consumer engagement initiatives are redesigned. Realizing that there is more than enough money in the system, we hope to steer the conversation from how much to how well we spend our healthcare dollars.
It is our hope and expectation that The American Journal of Accountable Care will address several important themes, including:
And finally: What are the effects of accountable care on direct medical expenditures and the economy as a whole? Albert Einstein’s quote, “In the middle of difficulty lies opportunity,” is often applied to United States healthcare. While the accountable care movement will not—on its own—provide the cure for what ails healthcare in the United States, its implementation marks a critical step in the evolution of healthcare from volume to value. We intend that The American Journal of Accountable Care will promote innovative ideas and inform, stimulate, and advance the dialogue on the healthcare transformation process. We welcome your comments on the papers included in this issue and encourage submissions for future issues.Author Affiliations: From University of Michigan (AMF, DTM), Ann Arbor, MI; Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI.
Author Disclosures: The authors report no relationship or financial interest with any entity that would pose a conflict of interest with the subject matter of this article.
Address correspondence to: Donovan T. Maust, MD, North Campus Research Complex, 2800 Plymouth Rd, Bldg 16, Room 217W, Ann Arbor, MI 48109-2800. E-mail: firstname.lastname@example.org. Berwick DM, Nolan TW, Whittington J. The triple aim: care, health, and cost.Health Aff (Millwood). 2008;27(3):759-769.
2. Perry RE. Building the infrastructure AJAC. 2013;1(1):13-14.
3. Patel K. Collaborative care before accountable care: achieving low cost, high quality care through a regional collaborative in Florida. AJAC. 2013;1(1):5-9.