ACO fears will be addressed, maybe alleviated

With the recent publication of the proposed rules regarding accountable care organizations (ACO), the topic has hit a fever-pitch level throughout the healthcare industry. Payers are particularly worried that the current ACO model could lead to antitrust issues, allowing groups of providers to band together and price gauge insurers. AHIP is so concerned that it submitted comments last week on the matter to the Federal Trade Commission and the Department of Justice.

So it should come as no surprise that AHIP has included some key sessions in this year's Institute addressing the growing ACO antitrust fears.

Deloitte consultants will address these concerns head on during their session Thursday morning. They will explore how ACOs can improve quality, efficiency, and--perhaps most importantly to attendees--preserve competition in the marketplace. You'll also hear about a capabilities framework that outlines key competencies for ACOs.

A separate group of healthcare consultants will discuss the critical role of payers in payment reform models during a Thursday afternoon session. Folks from Pacific Business Group on Health, Global Health Advisors, and Cognizant Business Consulting will examine how ACOs can drive innovation, quality improvement, and increase collaboration among health plans, hospitals, and physicians. Plus, you can learn about ACO's operational elements, including infrastructure, financial modeling, quality improvements and operations.

The final Thursday session presents lessons learned from providers in achieving high-value healthcare. Execs from Geisinger Health System and Marshfield Clinic will analyze the strategic issues posed by the new ACO program in light of their own business environments, including the implications for Medicare Advantage, commercial contracts, and other federal and state opportunities. This could be a valuable hour spent to help payers better understand providers' side of the ACO arrangement.

Related Articles:
ACOs: Wolves in sheep's clothing
Navigating the pros and cons of ACOs in Medicare Shared Savings Progras
AHIP: Don't give providers too much power in ACOs