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Reducing the Risk of Risk-Based Arrangements: Vendors Enabling the ACO

by John Moore lll | February 07, 2017

Join us on February 14th at 1pm ET for our next free webinar when Jennifer Rogers will share highlights from her upcoming report, “Reducing the Risk of Risk-Based Arrangements: Vendors Enabling the ACO.”

We’ll cover:

  • Viability, trending, and projections for the ACO model
  • Look at needs of new ACOs
  • Look at vendors filling those needs
  • Recommendations for HCOs and the ACO Enabler vendor niche

From the report’s executive summary:

“As healthcare continues to advance from volume-based fee-for-service (FFS) reimbursement models to value-based models, healthcare organizations (HCOs) need to embrace two key concepts to transform to an entirely new business model:

  1. Reimbursement for quality and value
  2. Managing both population and individual health

Vendors (“ACO Enablers”) with turnkey solutions are available to support payers and HCOs with what can be an overwhelming transformation, and for what initially may be only a fairly small portion of their overall attributed or assigned population and associated revenue. Value-based care (VBC) alternative payment models vary by their risk reimbursement structure and include Accountable Care Organizations (ACOs), bundled payments, primary care medical home models, and even quality-based payment arrangements. This report focuses on the ACO model and the vendors that specialize in supporting that particular model. In healthcare, as with any industry, a transition in business models is fraught with risk and uncertainty. How do potential ACO participants reduce their overall business risk (financial, operational, clinical, satisfaction) in order to be successful?”

Additional definition around the ACO Enabler:

ACO Enablement Webinar blog post table

The first part of the report identifies key components and requirements of at risk providers and ACOs, as well as reviews ACO market growth and challenges encountered.

The second part of the report provides assessment and guidance based on these criteria, including the technology challenges and solutions ACO Enablers are providing, along with a detailed look at specific vendors.

We conclude with projections of the future market trajectory, as well as recommendations for both ACOs and the Enabler Vendor niche.

Based on briefings with 10 ACO Enabler vendors as well as extensive secondary research, this Market Scan Report from Chilmark Research investigates the market and technology challenges of setting up an ACO and potential solutions:

  • What technology gaps do ACOs most need to fill in order to be successful?
  • What are the challenges to filling those gaps? Are they able to be filled with current technology and legacy vendors or not?
  • What partners, if any, does the vendor rely on to provide technology solutions to ACOs?
  • Where are ACOs overcomplicating their technology infrastructure and need to simplify solutions and vendors?
  • Where do significant gaps remain that HCOs struggle to fill

 

The report offers recommendations for both HCOs and vendors, including:

  • Do not hesitate to launch an ACO due to changing political administrations – driving increased value at lower costs is the right goal that will sustain throughout any specific changes in policy
  • Start small even in the absence of sophisticated IT and analytics, achieve small successes in managing utilization, improving outcomes, and engaging consumers, and measure as you go
  • Look for an Enabler vendor with experience that fits your market and your current stage of VBC readiness
  • Develop solutions for converging provider-payer models, addressing needs along the healthcare value chain vs directed at a traditional purchasing entity
  • Partner with more advanced ACOs to drive PHM strategies beyond the defined ACO population into the broader community; highest impact starting points include caregiver support, behavioral health, substance abuse, transportation, and food insecurity

Be sure to join us on February 14th at 1pm ET to hear highlights from this first-of-its-kind report.

Stay up to the minute.

“As biometric data becomes cheaper and easier to collect through smart sensors, devices, and mobile apps, expect to see more innovations in consumer health.”

-Alicia Vergaras