Insurers embrace private sector ACOs


The nation's largest insurance companies are launching hundreds of ACOs, and some healthcare providers say they are more enthusiastic about these private-sector organizations than their Medicare counterparts, reveals the Modern Healthcare publication.

Good concept: ACOs are designed to improve care and decrease health spending by offering joint financial incentives for providers to manage patients' health. The ACO model is now being test-piloted through the Medicare program. Although early results from those Medicare pilots have been mixed (see Healthcare Value Wire), private insurers appear to be enthusiastic about the ACO concept.

For instance, Robert Downs, head of Aetna's Northern New England market, tells the publication that the insurer is considering launching an additional 200 ACO deals. Aetna recently formed five new ACOs in Maine, bringing its total number of ACO contracts to 27. Meanwhile, UnitedHealthcare plans to double its accountable care contracts over the next five years. Currently, the insurer's ACO contracts include more than 575 hospitals, 1,100 medical groups, and 75,000 physicians nationwide.

Private-sector ACOs are gaining steam with healthcare providers because they appear to allow more leeway to design benefits that encourage plan members to use network providers. Some participants in Medicare ACOs have complained that Medicare does not let them use financial penalties to keep beneficiaries in their network, making it harder to control costs and quality.

ACO Guide: The Health Intelligence Network’s Essential Guide to Accountable Care Organizations answers key questions so that hospitals, PHOs, IPAs and other physician organizations, networks or group practices can assess market position and readiness for the ACO model and move quickly to improve profitability and market share.


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