Accountable Care in New York State: Emerging Themes and Issues
See the related press release.
Accountable care, an early example of value-based purchasing, is a transformational way of delivering health care that is experiencing remarkable growth in New York State. As of January 2015, 27 groups were participating in Medicare’s accountable care programs. These accountable care organizations (ACOs) vary widely in type of sponsorship, management structure, and past investment in necessary infrastructure; they consequently have different financial incentives and may be positioned differently for success in accountable care.
United Hospital Fund staff conducted semi-structured interviews with leaders from many of these groups about their early experience as an ACO; this report collects and explores the themes that emerged in those interviews. An accompanying quantitative report gives additional detail on the ACOs’ makeup, organizational type, location, and financial performance, along with aggregated results on quality measures.
Overall, those participating believe that the ACO model has the potential to improve care and reduce costs; many are now pursuing accountable care contracts with payers other than Medicare. They also agreed, however, that some design elements of the Medicare Shared Savings Program have hampered their ability to succeed, particularly matters related to patient attribution and performance targets.
As New York pursues value-based purchasing and expands the accountable care model beyond Medicare, providers, payers, and policymakers can learn from the experience of the organizations now participating in Medicare’s ACO program.
See the accompanying report, New York's Medicare ACOs: Participants and Performance.