Research: Private-Payer ACOs Larger, More Advanced than Public Counterparts

Dec. 22, 2014
The perception that most accountable care organizations (ACOs) are following Medicare’s lead might be inaccurate, according to recent research.
The perception that most accountable care organizations (ACOs) are following Medicare’s lead might be inaccurate, according to recent research. 
Led by Valerie Lewis, Ph.D, an assistant professor of health policy and clinical practice at the Dartmouth Institute, a group of researchers examined ACOs in both private payer and public payer models. They used an analysis of the National Survey of Accountable Care Organizations to determine that private payer-led models include more downside risk and upfront payments. 
While two-thirds of ACOs had a contract with Medicare, more than the 50 percent who had one with a private payer, those in the private payer model were more likely to featured an integrated delivery system (69 percent vs. 36 percent), a hospital (72 percent vs 53 percent), and higher care management capabilities (38 percent vs 28 percent). There were also more physicians and specialists in a private payer ACO contract.
Those in private models were more likely to have pay-for-performance initiatives (97 percent vs 85 percent), such as patient centered medical homes, public reporting (92 percent vs 80 percent) and risk-based contracts (83 to 55 percent). Most ACOs (57 percent) had only one payer contract, according to the researchers’ findings.
The findings were published in the American Journal for Managed Care.

Sponsored Recommendations

Going Beyond the Smart Room: Empowering Nursing & Clinical Staff with Ambient Technology, Observation, and Documentation

Discover how ambient AI technology is revolutionizing nursing workflows and empowering clinical staff at scale. Learn about how Orlando Health implemented innovative strategies...

Enabling efficiencies in patient care and healthcare operations

Labor shortages. Burnout. Gaps in access to care. The healthcare industry has rising patient, caregiver and stakeholder expectations around customer experiences, increasing the...

Findings on the Healthcare Industry’s Lag to Adopt Technologies to Improve Data Management and Patient Care

Join us for this April 30th webinar to learn about 2024's State of the Market Report: New Challenges in Health Data Management.

Findings on the Healthcare Industry’s Lag to Adopt Technologies to Improve Data Management and Patient Care

2024's State of the Market Report: New Challenges in Health Data Management