Value and Performance of Accountable Care Organizations: A Cost-Minimization Analysis

Parasrampuria, Sonal; Oakes, Allison H.; Wu, Shannon; Parikh, Megha; Padula, William V.

doi:10.1017/s0266462318000399

Cited by 5 publications

(10 citation statements)

References 8 publications

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Section: Resultsmentioning

confidence: 99%

“…A division of spending amounts on integrated care teams was also analysed through ACOs across the United States (Parasrampuria et al, 2018). A similar bundled payment system such as the one above was used where providers were given pre-set payments based on expected clinical usage (Parasrampuria et al, 2018). ACOs that had higher quality were noted to have an average savings of US$117 per beneficiary annually, while middle tier ACOs had average savings of US$176.42 per beneficiary annually, and lower tier ACOs had over expenditures of US$21.23 annually per beneficiary (Parasrampuria et al, 2018).…”

Section: Resultsmentioning

confidence: 99%

“…A similar bundled payment system such as the one above was used where providers were given pre-set payments based on expected clinical usage (Parasrampuria et al, 2018). ACOs that had higher quality were noted to have an average savings of US$117 per beneficiary annually, while middle tier ACOs had average savings of US$176.42 per beneficiary annually, and lower tier ACOs had over expenditures of US$21.23 annually per beneficiary (Parasrampuria et al, 2018). The findings of this study paint initial ACO quality as large influencers of its ability in generating cost and expenditure savings (Parasrampuria et al, 2018).…”

Section: Resultsmentioning

confidence: 99%

“…As borne out by the experience of a literature search, ACOs with higher quality were more likely to generate savings (Parasrampuria et al, 2018). This is because ACOs with higher quality have the capability available to implement clinical and fiscal structures that generate sustainable savings, which their lower-spending counterparts do not (Parasrampuria et al, 2018). Derived from this example, it must be noted that OHTs must be large enough and cater to significantly sized populations in order to spend large sums of money in order to generate effective savings.…”

Section: Discussionmentioning

confidence: 99%

“…In terms of streamlining services to lower costs, it's also important to mention how initial ACO quality and spending can affect their ability in generating savings (Parasrampuria et al, 2018). As borne out by the experience of a literature search, ACOs with higher quality were more likely to generate savings (Parasrampuria et al, 2018).…”

Section: Cost and Efficiencymentioning

confidence: 99%

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Expectations of the Ontario Healthcare System following the Implementation of Ontario Health Teams

Naqvi

2022

Journal of Health Management

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With the arrival of Ontario Health Teams (OHTs), healthcare providers, clinicians and patients seek to witness the efficacy of an integrated care model. OHTs are built on the concept of healthcare integration, coordinated care, shared fiscal and clinical accountabilities between multiple healthcare service providers, as well as bridging the gaps between the clinical, social and health promotional aspects of care delivery. This meta-narrative review seeks to examine, compare and determine the efficacy of the integrated care model using cross-sectional studies from around the world to see how integrated care effects health related outcomes. The efficacy of the model will be determined by evaluating the abilities of other integrated care models to reduce healthcare expenditures, improve coordination of care between healthcare service providers, bolster patient satisfaction and health outcomes, minimise emergency and life-threatening cases, lower emergency hospital admission rates as well as provide a comprehensive set of healthcare services including biomedical, mental and social supports. For future applications, this study could be used as a guideline to highlight areas of improvement in integrated care models, as well as to evaluate benefits of existing models and determine best approaches forward.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Cost and Efficiencymentioning

confidence: 99%

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Expectations of the Ontario Healthcare System following the Implementation of Ontario Health Teams

Naqvi

2022

Journal of Health Management

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How to facilitate the introduction of value‐based payment models?

Leao,

Pavlova,

Groot

2023

Health Planning & Management

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Value‐based payment (VBP) models are designed and implemented to improve outcomes at the same or lower costs. Their adoption requires significant changes in the way healthcare organisations and insurance companies operate. Usually, before VBP models are widely implemented, pilot projects are conducted. Payers need to have a comprehensive set of requirements to enter into agreements with healthcare organisations on these pilots. In this short communication, we outline key elements reported in the literature, inside and outside healthcare organisations, as well as within the contract, that need to be considered in a pilot VBP model. Discussions regarding the introduction of VBP models may be strongly affected by external contextual factors, including regulations, which are outside the control of healthcare organisations. It requires collaboration between organisations, including primary care organisations and hospitals, while within organisations, it frequently requires creating multidisciplinary teams. The focus is on ensuring transparency, collaboration, and shared decision‐making, realised by standardising communication processes and regular meetings. Additionally, effective leadership is needed, in which leaders set goals and priorities, as well as manage change. In the contractual agreements between payers and healthcare organisations, outcome measures need to be adequately defined and measured, including individual patient outcomes and composite scores, as well as absolute and relative performance measures. These measures should be tested periodically and catered to the organisations adopting the model. Also, incentives should have adequate size and frequency and be intrinsic and extrinsic. The consideration of these sets of key elements by the payers is essential when implementing VBP model pilot projects.

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To What Extent Are ACO and PCMH Models Advancing the Triple Aim Objective? Implications and Considerations for Primary Care Medical Practices

Cantiello

2022

Journal of Ambulatory Care Management

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Accountable care organizations (ACOs) and patient-centered medical homes (PCMHs) have emerged to advance the health care system by achieving the Triple Aim of improving population health, reducing costs, and enhancing the patient experience. This review examines evidence regarding the relationship between these innovative care models and care outcomes, costs, and patient experiences. The 28 articles summarized in this review show that ACO and PCMH models play an important role in achieving the Triple Aim, when compared with conventional care models. However, there can be drawbacks associated with model implementation. The longterm success of these models still merits further investigation.

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Value and Performance of Accountable Care Organizations: A Cost-Minimization Analysis

Cited by 5 publications

References 8 publications

Expectations of the Ontario Healthcare System following the Implementation of Ontario Health Teams

Expectations of the Ontario Healthcare System following the Implementation of Ontario Health Teams

How to facilitate the introduction of value‐based payment models?

To What Extent Are ACO and PCMH Models Advancing the Triple Aim Objective? Implications and Considerations for Primary Care Medical Practices

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