ACOs and the Super Bowl

Sunday night 108.4 million people tuned in to watch 22 men enter the field of battle in a contest with an 11-inch leather ball. According to the NFL, the difference between the winners and the losers was only $44,000. The winners of the Super Bowl walked away with $88,000 per person and the losers a scant $44,000. However, we all know that there was much more at stake for these players. These men had faith that if they followed the plays they had practiced so many times before, then the victory they had dreamed of for so long would be theirs.

There is another battle on a very different battleground happening all over the U.S. It is over something much more crucial, but far fewer television cameras are involved. That battle is over healthcare. In many ways, we are losing the battle. Healthcare costs are on the rise. It is harder for providers to make do with smaller and smaller margins. Children and adults are finding it harder to access affordable medical care. The play that many are counting on for aid in this battle will be performed by accountable care organizations (ACOs). Just as the stakes for the Super Bowl are about more than the $88,000 prize, the stakes for ACOs are about more than shared savings.

Interest in ACOs continues to grow. On January 11, 2013, the Centers for Medicare & Medicaid Services (CMS) announced 106 additional ACOs in the U.S., bringing the total to over 500 nationwide (including nongovernment ACOs). CMS estimates that ACOs can save billions of dollars in health costs. The interesting thing is that no one has completely cracked the code on what will make this play successful, and with more and more players entering the fray, it is vital that we get this right.

There are many elements to an ACO. This year, KLAS will be launching a report series focused on those elements to help vendors and providers get this play right and learn from each other. Some of the reports in the series will be on the following topics:

·         EMR usability (coming in March)

·         ACO payers

·         Population health

·         ACO vendors

·         Meaningful use

·         Business intelligence

·         More to come…

If you are interested in receiving the reports in this series, please email Colin Buckley at colin.buckley@klasresearch.com or call me directly at 801.734.6511.

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