Measuring Progress in Accountable Care Webinar March 14, 2013 Speakers: Eugene A. Kroch, Ph.D., vice president and chief scientist at the Premier Research Institute. Patrick Falvey, Ph.D., senior vice president and chief integration officer at Aurora Health Care in Wisconsin and Illinois. Steven Blumberg, senior vice president/executive director of Health Solutions at AtlantiCare in New Jersey. Moderators: Anne-Marie J. Audet, M.D., MSc., The Commonwealth Fund Stuart Guterman, The Commonwealth Fund A Private Foundation Working Toward a High Performance Health System

Hawaii Puerto Rico Current Status of ACO Implementation in the U.S. Note: the sum of the ACOs reflects the total number of unique, publicly identifiable, confirmed private-payer ACOs as of 08/2012 and public-payer ACOs as of 01/2013.

1. Accountable Care Conceptual and operational framework to describe ACO along criteria essential to assess and track organizations transforming into the accountable care model (Dartmouth/Berkeley HA - 9/12. NCQA Accreditation Program. Early assessment of national progress towards accountable care: Health Research and Educational Trust (HRET ) national survey of hospital preparedness for accountable care; Fund Data Brief (Audet/Kenward/Joshi; August 2012). Hospital system perspective. Established a foundation to track evolution of ACO implementation: Fisher et al national survey of SSP/Pioneer/Private sector ACOs (approx 210 sites surveyed fall 2012). Results forthcoming. Support work to inform major issues surrounding vulnerable populations in the development and implementation of ACOs. ACO implementation of the Premier ACO Collaborative identified variation in key domains of ACO readiness (Kroch et al, Fund 2012). Fund Commission on a High Performance Health System (Guterman et al, 2012). 3 A Private Foundation Working Toward a High Performance Health System

Overall goal: To achieve a high performance health system that is organized to attain better health, better care, and lower costs 1.Strong Primary Care Foundation 2.Accountability for Quality of Care, Patient Care Experiences, Population Outcomes, and Total Costs 3.Informed and Engaged Patients 4.Commitment to Serving the Community 5.Criteria for Entry and Continued Participation That Emphasize Accountability and Performance 6.Multi-Payer Alignment to Provide Appropriate and Consistent Incentives 7.Payment That Reinforces and Rewards High Performance 8.Innovative Payment Methods and Organizational Models 9.Balanced Physician Compensation Incentives 10.Timely Monitoring, Data Feedback, and Technical Support for Improvement Key Elements for Successful Accountable Care Source: Commission on a High Performance Health System. High Performance Accountable Care: Building on Success and Learning from Experience (New York: The Commonwealth Fund, April 2011). A Private Foundation Working Toward a High Performance Health System

Future Priority Areas: Accountable Care Accountable Care development, implementation and tracking – Monitor development of ACOs – track progress in Medicare (Pioneer, MSSP); state Medicaid; private sector; Multi-payer ACOs. – Identify best practices for critical implementation activities: transition costs, engaging consumers; care management approaches for populations; measures of accountability. – Evaluate impact of accountable care on quality and costs. – Explore local market and community characteristics where ACOs are forming. – Identify other models for organized, population-based, accountable delivery systems. 5 A Private Foundation Working Toward a High Performance Health System

Priority Areas: Accountable Care Payment models to promote integration and population-based accountable care systems – Evaluate adoption of payment policies: bundles, episode-based, shared risk, dimensions of performance rewarded/penalized, impact on provider behavior, redesign and quality and costs. 6 A Private Foundation Working Toward a High Performance Health System

Priority Areas: Accountable Care Payment models to promote integration and population-based accountable care systems – Evaluate adoption of payment policies: bundles, episode-based, shared risk, dimensions of performance rewarded/penalized, impact on provider behavior, redesign and quality and costs. 7 A Private Foundation Working Toward a High Performance Health System

Measuring Progress in Accountable Care Webinar Q & A Session A Private Foundation Working Toward a High Performance Health System

Measuring Progress in Accountable Care Webinar Resources Slides from today’s panelists are available here: For Commonwealth Fund reports on ACOs, including the Premier Research Institute reports, visit: Organizations.aspx