ACOs Widespread, Yet Challenged
Last year, Cigna reported that it was engaged in 16 "collaborative Accountable Care" initiatives in 10 states, involving more than 3,350 physicians, and over 235,000 Cigna customers. Among other things, the report showed that medical costs for 2010 were significantly reduced, $27.04 per patient per month under the ACO, compared with other practices. Performance improvements were also generated, the report said.
As for NovaHealth, an independent physician association based in Portland, ME, Health Affairs reported that in 2011 patients in the program had 50% fewer inpatient hospital stays, 45% fewer hospital admissions and 56% fewer readmissions than unmanaged Medicare populations statewide. Since 2008, NovaHealth doctors participating in Aetna's Medicare Provider Collaboration program have provided care to approximately 750 Aetna Medicare Advantage members.
Early results reflect "new and many variations" in ACOs, McClellan said. "What works best in what circumstances is still very much emerging," he added.
"ACOs are remarkable strategies to improve care, quality and lower cost," Fisher said. "You, on the provider side, are struggling to test new models, and all of us are trying to learn new ways of practicing in partnerships that are more complicated."
Ultimately, "there is so much more opportunity in helping patients learn how to stay healthy and stay out of the emergency room," Fisher said. Providing "great attention to your sick patients gives you the chance to achieve savings," Fisher said. "That's where all the money is," he said.
Joe Cantlupe is a senior editor with HealthLeaders Media Online.
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