Willl the ACO concept move in to the private payer arena?

Will the ACO concept move in to the private payer arena? Seems likely. Many private insurance companies are embracing the same concepts that underscore the Medicare ACO initiatives and in so doing, are encouraging their participating providers to join them in adopting new payment methodologies that will reduce costs while improving quality of care. For example, UnitedHealthcare, one of the nation's largest managed care organizations, has posted the following statement on its website:

"UnitedHealthcare is evaluating a variety of value-based contracting strategies to increase quality, reduce medical costs, improve patient outcomes and share risk as well as responsibility for controlling medical cost trend.

UnitedHealthcare considers Accountable Care Organizations (ACOs) to be an important element of its value-based contracting strategy. The goal of value-based contracting is to move the delivery system toward increased collaboration between the health care community and greater emphasis on shared risk accountability for improved outcomes. The transformation of industry-wide payment models is evolving and will require a variety of strategies to suit the needs and diversity of consumers and health care providers in individual communities across the country. UnitedHealthcare is currently pursuing a variety of value-based contracting models from performance based contracting incentives to full capitation."

As a private physician practice, this is a continuing trend you need to stay on top of. If the trend does continue, you can bet it has the potential to impact the econcomics of your medical practice.

UPDATE: After I wrote this blog post, CIGNA announced new ACO agreements with providers.

http://www.modernhealthcare.com/article/20120718/NEWS/307189960?AllowView=VW8xUmo5Q21TcWJOb1gzb0tNN3RLZ0h0MWg5SVgra3NZRzROR3l0WWRMVGJVL3dKRWxiNUtpQzMyWmVzNW5RWUpicWg=&utm_source=link-20120718-NEWS-307189960&utm_medium=email&utm_campaign=mpdaily#

About the Author

Reed Tinsley CPA

This article is written by Reed Tinsley, a Houston, TX-based CPA with over 30 years of experience advising physicians and medical practices across Texas and the United States. Reed holds certifications as a Certified Valuation Analyst (CVA), Certified Healthcare Business Consultant (CHBC), and Certified Financial Planner (CFP), specializing exclusively in the healthcare sector. He is a published author, nationally recognized speaker, and trusted advisor to physicians on accounting & tax, practice management, and financial planning. Schedule a Free Consultation.