Four accountable care organizations that are meeting their goals in increasing quality of care while controlling costs say not everything is working out to their satisfaction — particularly, transitioning from fee-for-service to value-based payment models.
These health systems showed promising results. AtlantiCare reported a 40% drop in hospital admissions. Fairview said colon cancer screenings were up from about 62% to nearly 70%, and patient utilization was down by about 13% in one year. Memorial saved the state health department $20 million, and Presbyterian improved care management and reduced costs through oversight of entire care episodes.
But the report said pacing of the shift to new payment models for physicians was a stumbling block.
The pacing problem is because of the challenges of setting up fully integrated coordinated care systems while trying to simultaneously change the payment models to reward physicians based on value, efficiency and outcomes, rather than merely on a fee-for-service basis, said Steve Blumberg, senior vice president and executive director at AtlantiCare Health Solutions.