ACO Shared Savings is Top Payer Partnership
The most prevalent arrangement for Medicare ACO contracting is 'shared savings upside,' or what is known within the industry as a one-sided risk model, survey data shows.
Early adopters of Medicare accountable care organizations have a preference for a one-sided risk model while commercial ACO participants look for care management fees, according to a survey released Wednesday by Premier healthcare alliance.
The Premier survey looks at 85 payer arrangements covering 1.8 million covered lives for 22 participants of its PACT (Partnership for Care Transformation) population health collaborative program.
The results reflect "the journey to population health management," Joe Damore, vice president, Population Health Management Premier, stated during a Wednesday press conference. "The organizations we work with are in the process of redesigning care and also redesigning their payer arrangements to support the new care model."
For the survey respondents, the payer arrangements fall into five categories:
1. Medicare and Medicare Advantage (35%)
2. Commercial (33%)
3. Medicaid (12%)
4. Self-insured employers (9%)
5. Provider-owned plans (11%)
The most prevalent arrangement for Medicare ACO contracting is shared savings upside or what is known within the industry as a one-sided risk model. These contracts involve a per capita expenditure target. As Damore explained, "if you are below that target you share in the savings with the federal government."
- No Employee Satisfaction, No Patient-Centered Culture
- RN Named Chief Patient Experience Officer
- As Retail Clinics Surge, Quality Metrics MIA
- Medicare Cost, Quality Data Tools Weak, Says GAO
- Providers' Push to Consolidate Roils Payers
- Population Health Pays Off for NY Collaborative
- AMA Pushes Lame Duck Congress for SGR Repeal
- How Payers Are Curbing Behavioral-Health Cost Drivers
- How Simple Data Analytics is Driving Physician Incentives
- Medicare to Finally Pay Doctors for Care They Were Giving Away