Health Care Opinion Leaders Weigh in on Barriers to Integrated and Accountable Care

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<p>Nearly nine of 10 leaders in health care and health care policy believe that a lack of incentives and the current financial interests of providers and other stakeholders are holding back progress in achieving greater integration and accountability in health care delivery, according to the latest Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey, published today.</p>
<p>The survey's findings are discussed in a <a href="/publications/publication/2010/jul/health-care-opinion-leaders-views-delivery-system-innovation-and">Commonwealth Fund data brief</a> and the need for accountable care is addressed in related Fund Blog posts by U.S. Secretary of Health and Human Services <a href="/blog/2010/ensuring-success-must-focus-patients-eliminating-inefficiencies">Kathleeen Sebelius</a> and former U.S. Senator <a href="/blog/2010/reason-optimism-key-roles-state-providers-insurers">David Durenberger</a>.</p>
<p>Health care leaders also identified potential ways to address barriers to delivery system innovations that aim to increase accountability and coordination of providers. For example, 65 percent support providing special payment arrangements to accountable care organizations (ACOs)—provider-led health care systems that are accountable for patient health outcomes and for coordinating the totality of patient care. The same proportion of respondents supports giving providers financial incentives to practice in ACOs. Both of these policies are reflected in provisions of the new health reform law, the Patient Protection and Affordable Care Act.</p>
<p>While a majority of opinion leaders surveyed support the growth of more-integrated models of care delivery, like ACOs, nearly three-quarters also said they were concerned or very concerned with providers acquiring excessive market power and dominance. To safeguard against such undue market share, a majority of health care leaders (56%) support regulation of ACO payment rates in regions with insufficient market competition, much like how a public utility is regulated.</p>
<p>"Across the board, leaders in health care say that our current perverse financial incentives are the chief barrier to implementing accountable and integrated systems of care that would improve quality and efficiency," said Karen Davis, president of The Commonwealth Fund. "The good news is that the Affordable Care Act goes a long way toward overcoming these financial barriers, and paving the way for a high-performance health system."</p>