Accountable Care Organizations in 2013
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Healthcare Benchmarks and Metrics September 2013 www.hin.com The Healthcare Intelligence Network • 800 State Highway 71, Suite 2 • Sea Girt, NJ 08750 888-446-3530 • [email protected] Accountable Care Organizations in 2013 : ACO Leadership Shifts to Physician-Hospital Organizations
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This HINtelligence report has data on ACO trends in 2013 as reported by 138 healthcare companies, including ACO program components, results and ROI, and the greatest successes achieved by accountable care organizations in respondents' own words. The number of accountable care organizations led by a physician-hospital organization (PHO) nearly doubled over the last year, according to the third annual ACO survey conducted by the Healthcare Intelligence Network. As the ACO model finds its feet, administration has changed hands from hospitals in 2011 to physician-led in 2012 to PHOs in 2013 — a year when the number of public and private ACOs in the country swelled to almost 500. Almost one in three ACOs is PHO-led.
Transcript of Accountable Care Organizations in 2013
Healthcare Benchmarks and Metrics September 2013
www.hin.comThe Healthcare Intelligence Network • 800 State Highway 71, Suite 2 • Sea Girt, NJ 08750
888-446-3530 • [email protected]
Accountable Care Organizations in 2013: ACO Leadership Shifts to Physician-Hospital Organizations
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www.hin.com | ©2013 Healthcare Intelligence Network
Septeber 2013 • ACOs in 2013
Accountable Care Organizations in 2013: ACO Leadership Shifts to PHOs
The number of accountable care organizations led by a physician-hospital organization (PHO) nearly doubled over the last year, according to the third annual ACO survey conducted by the Healthcare Intelligence Network. As the ACO model finds its feet, administration has changed hands from hospitals in 2011 to physician-led in 2012 to PHOs in 2013—a year when the number of public and private ACOs in the country swelled to almost 500. Almost one in three ACOs is PHO-led.
Composition of the popular care delivery model is shifting as well, with hospice, long-term care and home health exhibiting more skin in the ACO game in 2013. For example, the number of ACOs with hospices more than doubled in the last 12 months — from 19 percent to 42 percent. (See figure below.)
After several years in the ACO trenches, healthcare companies are more realistic about the time needed to solidify the ACO. One-fifth recommend more than two years for ACO construction, versus the 5 percent who suggested a 24-month window in 2012. Today’s ACO is larger, with 39 percent comfortably accommodating 5,000 to 9,999 lives (versus 24 percent reporting ACOs of this size one year ago).
Survey Highlights�� The numbers of existing and planned ACOs continue to rise from 2012 to 2013.
�� More ACOs include the uninsured in 2013—from 5 percent in 2012 to 14 percent this year.
�� About 62 percent of ACOs offer a patient portal to its membership, a new metric identified by the 2013 survey.
�� Patient engagement is weighted more heavily when evaluating ACO success in 2013.
3.2%
25.8%
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32.3%
38.7%
41.9%
51.6%
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0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0% 100.0%
Other
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ACO Provider Participants
HIN ACO Survey: August, 2013
Which providers participate in your accountable care organization?
© 2013
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�� Staff/management buy-in continues to be the greatest challenge of ACO development in 2013. This hurdle was reported by 23 percent of this year’s respondents.
�� For ACOs preparing to launch in the next 12 months, 44 percent will be led by PHOs.
Program Components�� Evidence-based care, care transition management, electronic health records (EHRs)
and case management are the most commonly reported components of respondent ACOs.
�� Clinical outcomes, still the most critical measure of ACO success in 2013, rose slightly in importance to this year’s respondents—from 85 percent in 2012 to 88 percent this year.
�� The use of NCQA measure sets to evaluate ACO quality and efficiency dropped from 38 percent in 2012 to just 8 percent in 2013. HEDIS® and CMS measure sets were most popular this year.
�� The measurement of provider satisfaction as an ACO success metric dropped from 52 percent in 2012 to 32 percent in 2013.
Results and ROI�� This year’s survey respondents have significantly dialed down the ROI they attribute
to the ACO model, with no 2013 respondents reporting ROI between 2:1 and 3:1 (versus 9 percent in 2012). However, 4 percent of 2013 respondents report ROI of less than 2:1, versus 0 percent of 2012 respondents.
�� The most impressive impact of the ACO model is in the area of care coordination, say 71 percent of respondents.
�� Just over half —52 percent—have experienced a decrease in hospital readmissions that they attribute to accountable care.
�� The cost of an accountable care organization is still among the top three challenges of the ACO model, say 2013 respondents, but compared to 12 months ago, poses somewhat less of a barrier. The percentage of respondents reporting cost as an ACO challenge dropped from 17 percent in 2012 to 14 percent this year.
HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA)
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www.hin.com | ©2013 Healthcare Intelligence Networkwww.hin.com | ©2013 Healthcare Intelligence Network
Greatest Successes Achieved by Accountable Care Organizations
�� “Decreased hospital readmissions; decreased cost of the beneficiaries.”
�� “Improved performance to 90th+ percentile HEDIS® on several metrics, reduction of ED visits/costs and implementation of embedded care management programs.”
�� “Since integrating embedded case management with the ACO, we have cut our 30-day readmissions at our hospital by 50 percent.”
�� “249 physicians are working together to achieve coordinated and collaborative care.”
�� “Provider enrollment through trust of PHO leadership.”
About the Survey
The third annual Accountable Care Organization survey was administered in August 2013 via the Healthcare Intelligence Network Web site at http://www.hin.com. Respondents were invited to take the survey via e-mail, e-newsletter and social media reminders throughout the month. A total of 138 healthcare companies responded to the survey, which asked 34 questions on ACO programs, with multiple responses possible on some questions. Some questions were open-ended, inviting write-in responses. Not all surveys were fully completed. Data is qualitative, and results were compiled by the Healthcare Intelligence Network.
Respondent Demographics
Responses to the August 2013 survey on ACOs were submitted by 138 organizations. Of 76 respondents identifying their organization type, 22 percent were hospitals or health systems, 15 percent were consultants, 9 percent were multi-specialty physician groups, 8 percent were PHOs, 7 percent were primary care providers, and 24 percent categorized their organization type as ‘Other.’
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Related Resource
Need more data from this survey? The Healthcare Intelligence Network has produced 2013 Healthcare Benchmarks: Accountable Care Organizations. This benchmarks report, now in its third year, delivers actionable data from 138 healthcare companies who completed HIN’s third annual ACO readiness assessment in August 2013. This book documents the numerous ways in which accountable care is transforming healthcare delivery, particularly in the area of care coordination, where the ACO model has had the greatest impact for this year’s respondents.
For more information on this 60-page report, please visit: http://store.hin.com/product.asp?itemid=4712
About the Healthcare Intelligence Network
The Healthcare Intelligence Network (HIN) is an electronic publishing company providing high-quality information on the business of healthcare. In one place, healthcare executives can receive exclusive, customized up-to-the minute information in five key areas: the healthcare and managed care industry, hospital and health system management, health law and regulation, behavioral healthcare and long-term care.
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