Accountable Care Organizations
Accountable Care Baseline Assessment
The Minnesota Department of Health commissioned a baseline assessment as part of the $45 million federal State Innovation Model (SIM) grant to implement the Minnesota Accountable Health Model. The assessment was designed to guide the development of tools and resources for providers and communities, and inform future monitoring efforts. Accountable Care Organizations (ACOs) are central to the Minnesota Accountable Health Model, which seeks to improve health in communities, provide better care and lower health costs.
The study included both qualitative and quantitative analyses, and drew on responses from more than 70 health plans and providers representing a majority of public and private health care markets.
A comprehensive report, Baseline Assessment of ACO Payment and Performance Methodologies in Minnesota for the State Innovation Model (SIM), is available.
An Accountable Care Organization (ACO) is a group of health care providers, with collective responsibility for patient care that helps coordinate services – delivering high quality care while holding down costs*. The ACO model creates an incentive for providers to efficiently and effectively manage the health of their patients regardless of where the patient receives care. Innovation lies in the flexibility of their structure, payments and risk assumption (i.e., how much “skin in the game” they have in terms of controlling costs and improving quality). That structure is likely to include Primary Care Providers (PCPs), specialists, a hospital, and other provider and community agreements/partnerships.
*Robert Wood Johnson Foundation
Examples of National ACO Models
Minnesota Medicaid ACO Models
Commercial ACO/Total Cost of Care (TCOC) Arrangements
With commercial ACO/TCOC agreements, health care providers and systems participate in a range of different delivery and payment arrangements aimed at achieving the Triple Aim. Agreements may include performance based on outcomes/quality and cost; varying levels of financial risk from shared savings to sub-capitation. Arrangements can be across multiple populations (self-insured, commercial and government) for some models.