In less than 18 months, Medicare will launch a shared savings program to reward primary care physicians, specialists, and hospitals that form accountable care organizations and collaborate in the redesign of care processes, improve care coordination, and promote high-quality, cost-efficient care. To receive payment, providers must demonstrate the impact their efforts have on specific quality-of-care and cost-reduction goals. Doing so is no small task. Quality Matters asked organizations that have been working toward these goals what advice they have for others. Read more »
One of the most challenging aspects of building an accountable care organization is bringing together physicians and hospitals to pursue quality-improvement and cost-reduction goals when their operations are not otherwise integrated. This case study provides an example of how a Boston-area independent practice association (IPA) forged relationships among physicians and a hospital to share in savings generated by improved quality and lower costs. The IPA built trust among its partners by demonstrating the value of investing a portion of those savings to create the infrastructure needed to achieve a common goal: better care for patients. Read more »
The formation and success of accountable care organizations depend on changes in payment methods to reward improved quality and efficiency. In January 2009, Blue Cross Blue Shield of Massachusetts announced that two provider groups (one of which is profiled in the case study) had agreed to a new five-year Alternative Quality Contract designed to achieve this goal. Dana Gelb Safran, Sc.D., senior vice president for performance measurement and improvement at the insurer, helped design the new contracting model. Read more »
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