Problem to Solve
Since the launch of the Affordable Care Act, accountable care organizations (ACOs) have become an increasingly important way for health care organizations to improve patient care and reduce health care costs. In the past decade, hundreds of ACOs have been created nationwide. What’s been missing, however, has been standardized and reliable ACO performance measurement and benchmarking.
A major health plan wished to effectively support and participate in a new standard measurement and benchmarking program for commercial ACOs being provided by a leading non-profit health care association. While the health plan had successfully launched several new ACOs in prior years, resulting in substantial gains in quality of care and cost reduction, it needed to ensure its preparedness to adopt the new ACO performance measurement program in time to align with its provider contracting deadlines, as well as meet its strategic goals.
In order to meet its tight timing requirements for adopting the standards of the new ACO performance measurement program, the health plan engaged Freed Associates (Freed) to support and drive its operational preparedness. Freed was selected for this engagement due to its expertise in ACOs, performance measurement and benchmarking, as well as its understanding and familiarity with this health plan.
Strategy and Tactics
The goal of the new ACO performance measurement program is to provide ACO participants with a comprehensive and meaningful understanding of commercial ACO performance, through aligned measurements, meaningful benchmarks and broad industry participation. Ensuring the health plan would be prepared to adopt the ACO performance measurement program’s standards, however, would mean a multi-faceted, strategic adoption effort by the health plan. All of the health plan’s preparedness work needed to be completed timely in order to meet its strategic goals and timelines.
Working in concert with the health plan’s quality improvement department, Freed launched and managed the activities of five distinct workgroups engaged to address the requirements of the commercial ACO measurement program. These work groups were charged with overseeing the following main initiatives:
Throughout all of these disparate efforts, Freed facilitated progress and alignment among all key internal health plan stakeholders, as well as with the non-profit association offering the ACO performance measurement program. The primary goal of this facilitation was to help the health plan proactively address all issues, questions and decisions regarding its adoption of the commercial ACO program.
Results and Conclusion
Through the collaborative efforts of the health plan’s quality improvement department and Freed, all major activities involving the health plan’s adoption of the commercial ACO program were completed successfully and on time. In addition, Freed successfully transitioned all of its ACO measurement preparedness activities to internal client staff members for future handling. As a result of this work, the health plan is ready to fully incorporate and adopt the commercial ACO measurement program standards and requirements into its provider negotiations and contracts.
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