4 'Value-Driving Elements' of ACOs Identified

Enhanced access and care coordination are among the cornerstone "value-driving elements" that must be implemented if patient-centered medical homes and accountable care organizations are to succeed.

That's one of several key findings in a sweeping report, Better to Best: Value-Driving Elements of the Patient Centered Medical Home and Accountable Care Organizations  issued Wednesday by the Patient-Centered Primary Care Collaborative. The report was crafted in partnership with The Commonwealth Fund and the Dartmouth Institute for Health Policy and Clinical Practice.

Paul Grundy, MD, president of the Patient-Centered Primary Care Collaborative said the report is most noteworthy for the consensus found among major providers, payers, and consumer groups. "It's the first time there's been such a broad agreement on a set of principles," said Grundy, who is also IBM's Global Director of Healthcare Transformation.

"There's an understanding from providers about what they want to provide and a consensus among buyers that they want to buy what the providers are offering. It is a national consensus across the broadest possible range of players on a journey toward care that's comprehensive, integrated, coordinated and accessible, versus care that's episodic, disintegrated, uncoordinated, inaccessible," he said.

Better to Best provides an action plan for core areas of consensus that were first identified at a one-day collaborative that PCPCC sponsored on Sept. 8, 2010. The collaborative agreed that:

• The goals of PCMHs and ACOs are better care, better health and lower costs.
• Improvement must be considered for lower costs and value to the consumer.
• Ongoing reportable measurements are needed to address these goals.
• Payment systems need to change and several payment models should be tested.
• Learning collaboratives and rapid learning environments are needed to establish an evaluation framework around these issues.