Health Plans Leading the Way on Delivery System Reform

Health plans have pioneered accountable care arrangements and are partnering with providers all across the country to change payment models and move away from the outdated fee-for-service system to one that pays for value, quality, and better health outcomes.  Here are two articles worth reading which highlight the private sector’s role in advancing accountable care:

  • The Washington Post’s Wonkblog had a post, Are health insurers on the way out?, which highlighted a map of existing private sector accountable care models that exist across the country.  The post said that, “These ACO models are showing pretty promising results,” and cited data from a recent Health Affairs article
  • The Council for Affordable Health Coverage’s piece, ACOs: a Triumph of Hope Over Experience, addresses many of the concerns some policy experts have raised about ACOs, including the potential for increase in hospital market concentration and the potential for cost shifting.  The Coalition points to the potential success of ACOs in the private market, writing “We are encouraged as well by the flourishing of private ACOs – wedded to a business care for better, cheaper care through risk sharing arrangements.  If these models prove successful, they will help guide the way for Medicare.”

Here are additional AHIP resources on ACOs:

  • A recent article in Health Affairs found that “not all providers are equally prepared to enter into accountable care arrangements and that flexibility and the technical assistance and support of health plans will be key to the success of these arrangements.”
  • AHIP’s Innovation Report Series highlights the innovative programs and services health plans have implemented to coordinate care for patients with multiple chronic conditions, improve patient safety, and promote prevention and wellness.

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