Half
of recently surveyed hospitals, clinics, and physicians in Minnesota are part
of an Accountable Care Organization (ACO), according to a first of its kind
analysis of Minnesota’s health care market.
ACOs
are broad, provider-based organizations that accept responsibility for the cost
and quality of care for a defined population. They are a key part of
Minnesota’s current efforts to improve health care, since ACOs aim to improve
quality and patient satisfaction while reducing costs.
The
report shows that about 40 percent of the commercially insured population in
Minnesota is receiving care from a provider affiliated with an ACO.
Though
ACOs have taken root in Minnesota, they have only achieved expertise in fewer than a third of the areas needed
for optimal implementation
of this care delivery model.
The
study looked at the capabilities that organizations need to succeed in an ACO
model, including population health management, disease management, patient
engagement, clinical decision support, performance management and utilization
management. Minnesota’s ACOs have achieved expertise in fewer than a third of
the areas needed for optimal implementation of this care delivery model. Larger
organizations, many of which are organized around hospitals, generally had
greater capabilities.
“When
you look at Minnesota’s providers, they’re moving in the right direction, but there’s
a lot more that we need to do to make progress on improving health through ACOs,”
said Health Commissioner Dr. Ed Ehlinger. “Through our State Innovation Model
work, we are giving providers and communities the tools to work with a broad
range of partners to promote health with a more coordinated approach.”
A
key goal of accountable care reform is to shift health care payments away from
fee-for service towards a model where payers reward providers for keeping
patients healthy while lowering costs. The
study indicates that fee-for-service payment still dominates in Minnesota, with
only a small portion of revenues tied to ACO arrangements. Two-thirds of surveyed providers indicated
that 10 percent or less of their organization’s revenue was at risk; a quarter
of respondents expected to see that figure rise to 30 percent by 2020.
“As
our state moves toward paying for better health care outcomes, as opposed to
the volume of procedures, this report establishes a baseline for measuring
much-needed progress,” said Human Services Commissioner Lucinda Jesson. “But
health care experts alone cannot accomplish this transformation. To be
successful, patients and community-based providers will play a critical role.
”The
Minnesota Department of Health commissioned IBM/KPMG to conduct a baseline assessment
as part of the $45 million federal State Innovation Model (SIM) grant to
implement the Minnesota Accountable Health Model. The study drew on responses
from more than 70 of the state’s largest health care providers and health plans,
representing a majority of the commercially covered lives in the state.
The
report’s recommendations include more education on population health
management, increasing access to meaningful data to manage the health of
patients across the spectrum of care, support to build partnerships with
non-clinical providers, and investments in technology and core infrastructure. The full recommendations and report are
available at www.dhs.state.mn.us/sim/SIM_ACO.html.
Media Contacts
Scott
Smith
MDH
Communications
651-201-5806
Scott.smith@state.mn.us
Martiga
Lohn
DHS
Communications
651-431-2729
Martiga.lohn@state.mn.us
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