The new year is barely weeks old and already the rush to create Accountable Care Organizations (ACOs) is in full swing. By the end of this month, the nation will be sporting upwards of 300 such organizations. Some estimates put the total number of covered lives at 30 million, split equally between Medicare and commercial insurance plans.
Hospitals are competing on this new playing field and as a result, some have called the ACO an “awesome consulting opportunity!” With all of this frenzy, I remain skeptical that we have arrived at the right set of measures to allow us declare one ACO a success and another a failure. What is truly needed is a set of definitive measures, beyond readmission rates and the like, that can tell us how a specific population is doing.
Recent reports from two sources are worth noting in this regard. Michael Stoto, a professor at Georgetown University doing a sabbatical at Academy Health in Washington, DC, is using his time there to work on a comprehensive model for population health and appropriate metrics. I look forward to seeing the finished product, as it is essential to the nation as we move forward in implementing population health initiatives.
Another great source is Matt Stiefel’s piece from a recent Institute of Medicine roundtable at Kaiser Permanente, linking the Triple Aim to Population Health and the ACO movement. Finally, my piece for The Governance Institute, entitled the Population Health Mandate, tackles some of the identical issues. The abstract is available to the general public. Members of The Governance Institute may download the complete article.
Taken together, these three pieces begin to build the platform we will need to make ACOs truly accountable for the care they provide. The secret sauce is population health and the understanding that health policy, quality and safety, and care coordination all have an impact on what we do at the bedside for every patient.