A collaborative accountable care model in three practices showed promising early results on costs and quality of care

Health Affairs

Volumn 31, Issue 11, 2012, Pages 2379-2387

  Salmon, Richard B ^a   Sanderson, Mark I ^a   Walters, Barbara A ^b   Kennedy, Karen ^c   Flores, Robert C ^d   Muney, Alan M ^a  

^a CIGNA HealthCare   (United States)

^b DARTMOUTH HITCHCOCK MEDICAL CENTER   (United States)

^c Medical Clinic of North Texas   (United States)

^d Cigna   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

CREATININE; HEMOGLOBIN A1C; LOW DENSITY LIPOPROTEIN CHOLESTEROL;

ADULT; AGED; ARTICLE; CHOLESTEROL BLOOD LEVEL; CLINICAL PRACTICE; CONCEPTUAL FRAMEWORK; COST CONTROL; CREATININE BLOOD LEVEL; DIABETES MELLITUS; FEMALE; FINANCIAL MANAGEMENT; HEALTH CARE COST; HEALTH CARE QUALITY; HEMOGLOBIN BLOOD LEVEL; HUMAN; HYPERTENSION; KIDNEY DISEASE; MAJOR CLINICAL STUDY; MAMMOGRAPHY; MULTICENTER STUDY; PATIENT CARE; PRACTICE GUIDELINE; REGISTERED NURSE; REWARD; SCREENING TEST; TREND STUDY; UNITED STATES;

ACCOUNTABLE CARE ORGANIZATIONS; ARIZONA; COOPERATIVE BEHAVIOR; DELIVERY OF HEALTH CARE, INTEGRATED; FEMALE; GROUP PRACTICE; HEALTH CARE COSTS; HUMANS; LOGISTIC MODELS; MALE; MANAGED CARE PROGRAMS; NEW HAMPSHIRE; PHYSICIAN INCENTIVE PLANS; PHYSICIAN'S PRACTICE PATTERNS; PRACTICE MANAGEMENT, MEDICAL; PROGRAM EVALUATION; QUALITY OF HEALTH CARE; TEXAS;

EID: 84871914512     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2012.0354     Document Type: Article

References (26)

1. Bodenheimer T. Coordinating care- a perilous journey through the health care system. N Engl J Med. 2008;358(10):1064-71.
2. McGlynn EA, Asch SM, Adams J, Keesey J, Hicks J, DeCristofaro A, et al. The quality of health care delivered to adults in the United States. N Engl J Med. 2003;348(26): 2635-45.
3. Orszag PR, Ellis P. The challenge of rising health care costs-a view from the Congressional Budget Office. N Engl J Med. 2007;357(18):1793-5.
4. Thorpe KE. Factors accounting for the rise in health-care spending in the United States: the role of rising disease prevalence and treatment intensity. Public Health. 2006; 120(11):1002-7.
5. Thorpe KE, Howard DH. The rise inspending among Medicare beneficiaries: the role of chronic disease prevalence and changes in treatment intensity. Health Aff (Millwood). 2006;25(5):w378-88. DOI: 1377/ hlthaff.25.w378.
6. Crosson FJ. The accountable care organization: whatever its growing pains, the concept is too vitally important to fail. Health Aff (Millwood). 2011;30(7):1250-5.
7. Fisher ES, McClellan MB, Bertko J, Lieberman SM, Lee JJ, Lewis JL, et al. Fostering accountable health care: moving forward in Medicare. Health Aff (Millwood). 2009;28(2): w219-31. DOI: 1377/ hlthaff.28.2.w219.
8. Barrett TM, Carlson G, Hoover W, Samitt C, Saxena K, Wilson B, et al. Accountable care organizations: 10 things you need to know about accountable care [Internet]. New York (NY): Institute for Health Technology Transformation; 2011 [cited 2012 Oct 11]. Available from: http://premierit.intel.com/servlet/ JiveServlet/downloadBody/6441-102-2-9618/ACO%20Report.pdf
9. Berwick DM. Making good on ACOs' promise-the final rule for the Medicare Shared Savings Program. N Engl J Med. 2011;365(19):1753-6.
10. Iglehart JK. The ACO regulations- some answers, more questions. N Engl J Med. 2011;364(17):e35.
11. Lowell KH, Bertko J. The Accountable Care Organization (ACO) model: building blocks for success. J Ambul Care Manage. 2010;33(1): 81-8.
12. Mulvany C. Medicare ACOs no longer mythical creatures. Healthc Financ Manage. 2011;65(6):96-104.
13. Van Citters AD, Larson BK, Carluzzo KL, Gbemudu JN, Kreindler SA, Wu FM, et al. Four health care organizations' efforts to improve patient care and reduce costs. New York (NY): Commonwealth Fund; 2012.
14. Crosson FJ. 21st century health care: the case for integrated delivery systems. N Engl J Med. 2009;361(14): 1324-5.
15. DeVore S, Champion RW. Driving population health through accountable care organizations. Health Aff (Millwood). 2011;30(1):41-50.
16. Congressional Budget Office. Lessons from Medicare's demonstration projects on disease management, care coordination, and value-based payment [Internet]. Washington (DC): CBO; 2012 Jan [cited 2012 Oct 11]. (Issue Brief). Available from: http://www.cbo.gov/sites/default/ files/cbofiles/attachments/01-18-12-MedicareDemoBrief.pdf
17. Correia EW. Accountable care organizations: the proposed regulations and the prospects for success. Am J Manag Care. 2011;17(8):560-8.
18. CMS.gov. Accountable care organizations (ACO) [Internet]. Baltimore (MD): Centers for Medicare and Medicaid Services; [last modified 2012 Apr 5; cited 2012 Oct 11]. Available from: https://www.cms .gov/ACO/
19. Centers for Medicare and Medicaid Services. Medicare Physician Group Practice Demonstration [Internet]. Baltimore (MD): CMS; 2011 Jul [cited 2012 Oct 11]. Available from: https://www.cms.gov/Demo ProjectsEvalRpts/downloads/PGP_ Fact_Sheet.pdf
20. Iglehart JK. Assessing an ACO prototype-Medicare's Physician Group Practice Demonstration. N Engl J Med. 2010;364(3):198-200.
21. Wilensky GR. Lessons from the Physician Group Practice Demonstration- a sobering reflection. N Engl J Med. 2011;365(18):1659-61.
22. National Committee for Quality Assurance. NCQA patient-centered medical home: a new model of care delivery: patient-centered medical homes enhance primary care practices [Internet]. Washington (DC): NCQA; [cited 2012 Oct 11]. Available from: http://www.ncqa.org/Portals/ 0/PCMH%20brochure-web.pdf
23. To access the Appendix, click on the Appendix link in the box to the right of the article online
24. Paulus RA, Davis K, Steele GD. Continuous innovation in health care: implications of the Geisinger experience. Health Aff (Millwood). 2008;27(5):1235-45.
25. Song Z, Safran DG, Landon BE, Landrum MB, He Y, Mechanic RE, et al. The "Alternative Quality Contract," based on a global budget, lowered medical spending and improved quality. Health Aff (Millwood). 2012;31(8):1885-94.
26. Berwick DM, Nolan TW, Whittington J. The Triple Aim: care, health, and cost. Health Aff (Millwood). 2008; 27(3):759-69.