California Stakeholders Endorse Plan to Standardize ACO Benchmarking

Dec. 19, 2017
The Integrated Healthcare Association (IHA) and Pacific Business Group on Health (PBGH) have announced that they are working together to develop a benchmarking framework for California ACOs (accountable care organizations).

The Integrated Healthcare Association (IHA) and Pacific Business Group on Health (PBGH) have announced that they are working together to develop a benchmarking framework for California ACOs (accountable care organizations).

In an effort to collect more meaningful quality and cost information and reduce burden on clinicians, California healthcare purchasers, plans and providers have indeed endorsed an initiative to standardize ACO performance measurement and benchmarking that could serve as a national model, the IHA and PBGH said.

Based in Oakland, IHA convenes a variety of healthcare stakeholders—including physicians, hospitals and health systems, purchasers, and health plans—that are committed to value-based, integrated care. San Francisco-based PBGH, with similar goals on improving the quality and affordability of healthcare, is a purchaser-only coalition, representing 60 public and private organizations across the U.S that collectively spend $40 billion a year purchasing healthcare services for 10 million Americans.

The ACO measurement and benchmarking initiative will launch in 2018 and include 18 clinical quality, hospital utilization and cost measures for care provided in 2017, ranging from recommended cancer screenings to comprehensive diabetes care to emergency department visits to the total cost of care per enrollee. In the following years, additional developmental measures will be added and tested, bringing the total to 35 performance measures, officials said.

“Given the high and variable costs and uneven quality of care across California and the nation, purchasers and payers increasingly are seeking to identify physicians, hospitals and other providers that deliver high-quality care at an affordable price through ACOs,” PBGH CEO David Lansky, Ph.D., said in a statement. “With upwards of 20 percent of consumers now using ACOs, we need a common yardstick to measure and benchmark ACO performance if we are going to improve quality and keep care affordable.”

Consistent commercial ACO performance measures, and statewide and national benchmarks can help health plans, physician organizations, and purchasers target performance improvement activities that advance the goal of high-quality, affordable, patient-centered care, IHA officials attested. To this end, IHA and the National Quality Forum (NQF) are working together to develop the benchmarking framework for California ACOs that could serve as a national model. Along with working to establish national ACO benchmarks, IHA and NQF will also collaborate on “developing next-generation ACO performance measures, including patient-reported outcomes, that capture what matters most to patients and improving their care,” officials from the two associations said.

“Developing a national benchmarking standard for ACOs and next-generation ACO performance measures will be critical to ensure meaningful measurement that minimizes reporting burdens, drives improved performance, and results in better, safer care for patients,” said NQF President and CEO Shantanu Agrawal, M.D.

Participants and supporters of the initiative so far include four of the state’s largest commercial health plans—Aetna, Anthem Blue Cross, Blue Shield of California, and Health Net—leading purchasers—Boeing, CalPERS, Covered California, and Google—and prominent providers participating in ACOs across the state, including Cedars-Sinai, Brown & Toland Physicians, HealthCare Partners, Hill Physicians, John Muir Health, MemorialCare Medical Foundation, Providence Health and Services, Sharp Rees-Stealy Medical Group, Stanford Health Care, Sutter Health, UC Davis Health, and others.

ACO providers welcome the initiative so far, especially the focus on making performance measurement more meaningful and less burdensome for providers. “We currently collect data for literally hundreds of distinct performance measures that vary from health plan contract to health plan contract,” said MemorialCare Medical Foundation CEO Mark Schafer, M.D. “Creating a single, comprehensive set of performance measures will help us focus on what matters most—improving patient care.”

As additional organizations join, an updated list of participating purchasers, health plans and provider organizations will be available online, along with more detailed information about the ACO initiative and measure set.

Sponsored Recommendations

Healthcare Rankings Report

Adapting in Healthcare: Key Insights and Strategies from Leading Systems As healthcare marketers navigate changes in a volatile industry, they know one thing is certain: we've...

Healthcare Reputation Industry Trends

Navigating the Tipping Point: Strategies for Reputation Management in a Volatile Healthcare Environment As healthcare marketers navigate changes in a volatile industry, they can...

Clinical Evaluation: An AI Assistant for Primary Care

The AAFP's clinical evaluation offers a detailed analysis of how an innovative AI solution can help relieve physicians' administrative burden and aid them in improving health ...

From Chaos to Clarity: How AI Is Making Sense of Clinical Documentation

From Chaos to Clarity dives deep into how AI Is making sense of disorganized patient data and turning it into evidence-based diagnosis suggestions that physicians can trust, leading...