To succeed in a value-based care environment, accountable care organizations (ACO) require a solid foundation built on five competencies of population health management: infrastructure, population evaluation, provider network, quality and safety, and waste reduction. Once the foundation is built, the healthcare organization can package this “asset” to enter into truly beneficial agreements as outlined in this groundbreaking Accountable Care Transformation Framework.
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About 40% of U.S. healthcare providers are participating in some type of shared accountability arrangement.. That means that the majority is on the sideline in a “wait and see” mode. Yet this trend will move forward, albeit in fits and starts, as purchasers and providers understand that they have oversimplified and undervalued what the other participants in the equation contribute. As the industry moves through three phases of vertical integration, fair-sighted accountable care initiatives will need to focus on at least three critical elements in designing their system for success in the steady state, including: 1) constructing the vertically integrated healthcare delivery system, 2) stratifying and allocating the risk, and 3) managing the financial risk.