ACO Models Focusing on Certain Conditions

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Karen Utterback By Karen Utterback 
Vice President, Product Marketing and Strategy, McKesson

ACO Models Focus on Chronic ConditionsA small number of accountable care organizations (ACOs) are beginning to focus on certain diseases or chronic conditions. Is your home health agency gearing up to compete?

Florida Blue, the insurer formerly known as Blue Cross and Blue Shield of Florida, has established ACOs for cancer patients in the Miami and Tampa areas during 2012, according to a report in American Medical News. The article also mentioned that dialysis provider DaVita has launched the Accountable Kidney Care Collaborative and is trying to establish an ACO for people with kidney disease.

The focus of ACOs on specific conditions may be the low-hanging fruit of the accountable care world. End-stage renal disease cost federal and commercial payers nearly $43 billion in 2010, and more than $124 billion was spent on cancer treatments the same year.

Cost savings are shared among providers in the ACO model, so finding effective treatments and interventions for a specific disease can help nearly every patient in the group. But if the entire ACO were composed of those with a certain disease, positive treatments could have far-reaching effects, both to the quality of life for patients and significant savings that providers could share.

Home health agencies can play a vital role in the ACO model, particularly in terms of disease management. Some agencies have developed programs that address specific morbidities such as diabetes, congestive heart failure or COPD.

Last year, we held a webinar series that addressed ACO strategies. The three webinars are:

  • ACO Overview
  • Addressing the Triple Aim
  • Measures of Success

I know that running your agency can sometimes feel like a juggling act, with day-to-day tasks competing with medium- and long-range planning, personnel issues, technology challenges and many other concerns. Talking about ACOs may seem like piling on, but accountable care organizations are gaining stature, traction – and dollars. You need to determine how your agency fits into an accountable care world.

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