More employers are turning to accountable care organizations as a lower-cost employer-sponsored benefits option with a higher quality of care, according to a report by Aon Hewitt and Polakoff Boland.
The report, which interviewed 674 U.S. employers, finds that 28 percent of respondents are interested or very interested in exploring ACOs, and 37 percent of respondents are somewhat interested. Another 24 percent of respondents are unsure, and 11 percent of respondents are not at all interested.
Quality of care is the primary factor 82 percent of respondents rely on in evaluating ACOs, which is followed by the ability to manage the total cost of care at 81 percent, patient outcomes at 66 percent and plan-provider pricing transparency at 47 percent.
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"ACOs are considered next-generation health care delivery models, consisting of teams of doctors, hospitals, and other health care providers and suppliers working together to coordinate and improve care for particular groups of patients," says Michael Cryer, MD and national medical director with Aon Hewitt. "ACOs reduce cost by providing plan participants the right care at the right time.
"By improving access to primary care, plan participants can avoid emergency room visits, which results in a financial reward for the ACO and shared savings with the sponsoring organization or organizations."
The report also reveals that 87 percent of respondents say it is necessary to have a primary care physician in the ACO to gain employee acceptance, and approximately 80 percent of respondents say awareness or reputation of the sponsoring organization is a key factor in positively influencing employees.
Seventy-one percent of respondents report having various ACO networks or models to choose from would be a critical or important positive influence on workers while 74 percent of respondents say limiting patients to only ACO network providers would negatively influence employees, and 66 percent of respondents say the limited history of ACOs would negatively impact employees.
"It's clear that ACO proponents need to educate the public about the trade-offs between networks," says Phil Polakoff, MD, MPH, MEnvSc and managing partner of Polakoff Boland. "ACO models help organizations reduce health care cost, waste and inefficiencies as well as support the movement from volume to value-based approaches.
"This volume to value-based shift can be seen in various employer practices today, such as pay for performance, accountable quality contracts, incentive compensation and bundled payments, which can serve as strong examples of similar successful models to employers and employees alike."
Regarding what extent each group should share in the ACO's cost management risk, respondents say medical groups at 23 percent, hospitals at 22 percent, health plans at 21 percent, employers at 18 percent and employees at 15 percent.
"The most feasible way to improve care and pricing is for health plans – and federal/state governments – to structure risk contracts with providers whereby physicians and hospitals are responsible for doing 'the right thing at the right time at the right cost,'" says Paul Klein, principal in the Health and Benefits Practice with Aon Hewitt. "That is the essence of accountability and will likely be the cornerstone of collaboration among stakeholders about how to drive efficiency and quality in the years ahead."
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