5 questions to ask when considering an accountable care strategy

With an annual employee health care spend that’s approaching $1 trillion, self-funded employers are essentially operating mini insurance companies. Innovative companies are embracing their role as leaders in this employer-driven health care economy, and they are increasingly taking advantage of new approaches to managing their employees’ health. For instance, today, 96 percent of large employers offer telemedicine services, 54 percent offer onsite or near site health centers, and 21 percent have incorporated accountable care organizations (ACOs) into their strategies—a figure that is projected to double by 2020, according to a recent survey by NBGH. These new approaches allow employers to break the traditional care model, improve health outcomes and the patient experience, and better control costs.

ACOs are organizations that empower health care provider groups, such as health systems and/or multi-specialty physician groups, to take accountability for the total cost and outcome of care for a population. While ACOs have been mostly promoted via the Affordable Care Act as a “value based” Medicare plan variant, the general concept has expanded to employer-sponsored health benefit plans.

ACOs represent an intriguing strategy where the buyers of health care, employers and their people who pay the bills, have aligned incentives with providers so that patients receive the right care, at the right time, at the right place, at the right cost, with the right outcome. This is what I see as the new patient’s bill of rights in this employer-driven health care economy. The sellers of health care, after all, are the providers of care itself — hospitals and physicians. It seems obvious that buyers and sellers should negotiate the terms of their agreement so that the patient’s rights are satisfied.