self-funded employers accountable care organizations patient's bill of rights

1. How do I know if my particular organization would benefit from an eACO?

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2. What should be our criteria when determining provider capabilities?

• An infrastructure in place to manage population health guided by value-based care principles;
• Unit costs that are more favorable than traditional carrier network rates for broad PPO networks; and
• Compensation models that reward providers for coordinated care, cost management, and reducing waste.

3. Should we contract with ACOs directly?

4. How do we ensure our employees understand the arrangement and take advantage of it?

• Help ensure that your employees understand the eACO on an ongoing basis—which providers are in that eACO network, how the costs compare to other options, and their choices if they can't have a specific care need met by the eACO.
• Drive employees to the eACO when they're seeking care, listing the eACO first in any search results, and helping them course correct when they aren't using the eACO. For example, flagging the eACO if they're making an appointment with an out-of-network provider, or pointing out an eACO would have been a more cost effective option on a post-appointment EOB.
• Make it as easy as possible for employees to access the eACO, from making appointments to paying for services.

5. Are there standards for reporting from ACOs so we can determine effectiveness?

• Establishment of population-based clinical targets, such as reductions in admission and closing gaps in care;
• Service and care coordination standards that ensure ease of navigation and access;
• Member engagement in care management; and
• Member satisfaction, which can be assessed through a Net Promoter Score (NPS), a standard measure of satisfaction that looks at how likely employees are to recommend their respective eACO.

Eric currently serves as National Leader of Value-Based Care at Collective Health. He is a 30 year veteran of the healthcare industry as an executive and consultant. As a Principal at Willis Towers Watson, Eric developed and grew the national Hospital Industry focus. He's a passionate advocate for change in our healthcare system, and his work has been featured in Reuters, Fox News, Inc Magazine and more.