ACOs Without the Rules: Private Sector Offers Route to Reform

In a similar vein, the Optum Institute's sustainable health communities, will be more free-form and probably more wonky than the CMS-issued ACO. Simon says the sustainable health community (SHC) model is a goal, rather than a single model, that will be met in several different ways. The community can include policy types, providers, and almost anyone with an idea about how to improve healthcare.

How SHCs improve healthcare quality, bend the cost curve, and increase satisfaction among employers, providers, patients, and payers will be up to each community?with the caveat that they produce the necessary results. "The communities will bring their own resources, culture, and patient preferences to the table," Simon told HealthLeaders Media. She explains that the key to success will be "if we have patients and providers engaged in a way that will improve population health."

SHCs will also address the common complaint that the ACO rule sets no requirements for patient accountability. "We'll want to see patients engaged in terms of their ability to make choices and manage their own health," Simons says.

Part think-tank and part community organizer, the Optum Institute plans to provide a wide range of support for the creation of SHCs, including research and analysis, community-based forums, executive education programs, public policy debates, and industry partnerships.

The results of the institute's first research study demonstrate the enormity of the task. The Optum Institute teamed with Harris Interactive on a national opinion survey to explore attitudes among physicians, hospital executives, and patients about quality of care, accountable care, and what it will take to move to high-performing local healthcare communities.