Brian Marcotte, president and CEO of the National Business Group on Health, offers recommendations for employers that are considering accountable care organizations (ACOs) and describes situations when an ACO is not a good fit.
Brian Marcotte, president and CEO of the National Business Group on Health (NBGH), offers recommendations for employers that are considering accountable care organizations (ACOs), such as using NBGH's ACO Journey Map, and describes situations when an ACO is not a good fit.
Transcript (slightly modified)
What recommendations does the National Business Group on Health have for employers considering accountable care organizations?
I would say for an employer, start by prioritizing: what are your top 5 markets that represent the bulk of your population or a higher percentage of your population? Then, ask your health plan or the ACOs in that market, depending on how you’re working, to take the Journey Map that we’ve developed and the toolkit that supports that and have them asses the ACOs in that market and bring back to you where they are on that maturity path.
So, you’ve gone from 150 ACOs, down to 5 critical markets, to the ACOs that are performing at a higher level in those markets, which then gives you the opportunity to go deeper on those ACOs and understand that where they are from a cost perspective versus market quality and consumer experience versus the market, rather than trying to figure out what 150 ACOs are doing.
Are there situations where ACOs are not a good fit? For instance, do big employers benefit more than small employers?
I think that it’s not so much about which ACOs are ready and who benefits more, it’s more about: is the ACO in a position to deliver something better than the market for an employer? A small employer could use the Journey Map to get a sense of comfort and confidence in an ACO’s capability as well. But, if an ACO isn’t ready, it at least gives the employer the opportunity to have a conversation—if not now, what’s it going to take to get you from point A to point B? Everyone understands what point B is, so that you will be ready and we will be ready to work together and implement you down the road.