Accountable care in both the public and private sector have continued to grow over the past several years, ushering in more experience and evidence on what is working and ways to continue evolving accountable care models. The Sixth National Accountable Care Congress (www.ACOCongress.com), November 16-18 in Los Angeles, will provide an unprecedented opportunity to discuss remaining barriers to widespread accountable care implementation, strategies to overcome them, and policies to encourage the continued growth and sustainability of the accountable care movement.
The Congress brings together leading policymakers, experts, and accountable care implementers to provide unique and in-depth insights on accountable care implementation and ongoing health care reform. The Congress will cover a variety of topics including strategies for risk contracting, innovative contract and payment arrangements, physician and patient engagement, state innovations in accountable care, health IT and mobile technology use, opportunities for specialty care and post-acute care integration, employer-led accountable care arrangements, and innovations in contracting for pharmaceuticals and devices. The Congress will also be a great opportunity to explore the future of accountable care contracting, practice, and policies as more organizations are driven to transition to alternative payment models.
WHAT IS AN ACO?
Accountable Care Organizations (ACOs) are groups of physicians, hospitals, and other providers that receive financial rewards for achieving patient-focused quality targets and demonstrating reductions in overall spending growth for their defined patient population. ACOs can be organized in a number of ways, ranging from fully integrated delivery systems to networked models within which physicians in small office practices can work together to improve quality, coordinate care, and reduce costs. ACOs can also feature different payment incentives, ranging from “one-sided” shared savings within a fee-for-service environment to a range of capitation arrangements with quality bonuses. In addition, ACOs are compatible with a range of other payment reforms, such as medical homes and bundled payments; they can help assure that these reforms lead to sustainable quality improvements and cost reductions. In sum, ACOs provide an ideal mechanism to transition from paying for volume and intensity to paying for value.
HOW IS ACO IMPLEMENTATION PROCEEDING ACROSS THE COUNTRY?
Since 2012, the Centers for Medicare & Medicaid Services (CMS) has recruited over 420 organizations across the country to participate in the Shared Savings Program and the Pioneer ACO Model, both of which aim to promote accountability for the care of Medicare FFS beneficiaries, coordinate care for all services provided under Medicare FFS, and encourages investment in infrastructure and redesign care processes. CMS has released financial and quality performance results for the first two years of MSSP and the first three years of the Pioneer Program and while a majority of these ACOs were able to attain quality improvement, only about a quarter were successful at reducing spending enough to qualify for shared savings. Meanwhile, CMS has finalized updated regulations for the MSSP that seek to improve the sustainability and success of the program. Furthermore, the Next Generation ACO Model will launch in January 2016, which is designed to provide additional payment options for those organizations willing to assume increase financial risk, coupled with beneficiary incentives to facilitate better coordination of care. Both the MSSP regulations and the Next Generation ACO Model seek to address participants’ concerns to date, including attribution, financial benchmark calculations, data sharing, beneficiary incentives, flexibility in payment arrangements, and other programmatic changes to create more stability and certainty. Additionally, recent passage of the Medicare Access and CHIP Reauthorization Act (MACRA) will continue to drive adoption of alternative payments models, including ACOs, bundled payments, and capitated payment arrangements.
Beyond Medicare ACO initiatives, interest and participation in accountable care reforms has been growing both in states and in the private sector. Several states, including Oregon, Colorado, Arkansas, Minnesota, New Jersey, and Washington have developed programs to support the transition toward accountable care models for either their Medicaid programs or state employees. There are now over 300 private sector ACOs with all of the major private health plans implementing payment reforms similar to the ACO model; like ACOs, these payment reforms include accountability for the full continuum of patients’ care, payment contingent upon improving the quality and coordination of care, and responsibility for cost management within a target budget. In tandem with the Medicare Shared Savings Program, the Pioneer ACO Model, the Next Generation ACO Model, and other innovative programs in Medicare, these private sector efforts will be instrumental in moving accountable care implementation forward as health care reform progresses.
WHO SHOULD ATTEND
- Executives and Board Members of Health Plans, Health Systems, Hospitals and Physician Organizations
- Medical Directors
- Nurses, Nurse Practitioners and Other Allied Health Professionals
- Pharmacists and Pharmacy Benefit Managers
- Representatives of Purchasers, including Private Employers and Public Purchasers
- Consumer Organization Representatives
- Federal and State Government Officials
- Health Care Regulators and Policy Makers
- Health Benefit Consultants
- Health Services Researchers and Academics
- Health Care Attorneys and In-house Counsel
- Chief Financial Officers Chief Innovation Officers
- Directors of Accountable Care
- Directors of Quality Management and Improvement
- Directors of Government Programs
- Directors of Medicare Programs
- Directors of Medicaid Programs
- Directors of Network Contracting
- Directors of Provider Relations
- Directors of Finance and Reimbursement
- Pharmaceutical Executives
- Pharmaceutical Consultants
ABOUT THE CONGRESS PRODUCERS
CAPG is the leading trade association in the U.S. for risk-bearing physician organizations. CAPG serves as the voice of physician groups practicing capitated, patient-centered, coordinated care. Our mission is to assist accountable physician groups to improve the quality and value of healthcare provided to patients. We provide support, advocacy, educational, and networking opportunities to our members, comprising more than 180 multi-specialty medical groups and independent practice associations (IPAs) across 29 states and Puerto Rico. Each year, the CAPG Annual Healthcare Conference attracts more than 1,600 attendees, and our joint National Accountable Care Congress, cosponsored with the Integrated Health Association, has drawn approximately 700 participants. Together with our member groups and strategic partners, CAPG will continue driving the evolution and transformation of healthcare delivery throughout the nation.
The Integrated Healthcare Association (IHA) is a non-profit multi-stakeholder leadership group that promotes healthcare quality improvement, accountability and affordability in California. IHA administers regional and statewide performance measurement programs, serves as an incubator for pilot programs and demonstration projects, and actively convenes diverse healthcare stakeholders for cross-sector collaboration on a variety of critical healthcare issues. IHA principal projects include the California Value Based Pay for Performance Program (the largest private physician incentive program in the U.S.), the measurement and reward of efficiency in healthcare, administrative simplification, healthcare affordability, bundled episode of care payments, and accountable care organizations.