ACOs in 2012: ACO Activity Doubles in 12 Months

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1 Healthcare Benchmarks and Metrics July 2012 ACOs in 2012: ACO Activity Doubles in 12 Months The Healthcare Intelligence Network 800 State Highway 71, Suite 2 Sea Girt, NJ info@hin.com

2 July 2012 ACOs in 2012: Activity Doubles in 12 Months Page 2 Second Annual Look at ACO Adoption and Activity Participation in accountable care initiatives has more than doubled in the last 12 months, according to 200 healthcare companies who completed the second annual Healthcare Intelligence Network survey on Accountable Care Organizations (ACOs). Almost a third of this year s respondents 31 percent participate in an ACO, up from 14 percent of respondents in And two-thirds of respondents said ACOs would have survived a challenge by the U.S. Supreme Court. SCOTUS upheld the healthcare reform bill in June The last 12 months have been a hotbed of ACO activity. Announcements of accountable care collaboratives and partnerships have been frequent, and CMS kicked off its Medicare Shared Savings Program (an ACO for Medicare beneficiaries) on April 1. Just over half of this year s respondents are participating in the CMS Shared Savings program. The number of ACOs with a hospital at the helm has dropped dramatically, from 32 percent in 2011 to around 5 percent. The survey found physician-led ACOs to be the most common, with a quarter of 2012 respondents indicating that physicians are administering their ACO. The typical ACO is smaller, too, as the number of active ACOs with 100 to 500 physicians dropped almost 50 percent in the last 12 months. Twenty-seven percent of this year s respondents report ACOs of that size, versus almost half of last year s respondents. This year s survey provided new data on other healthcare professionals in the ACO, ACO reimbursement models, and ACO impact. Respondents said care coordination has improved as a result of ACO activity, and hospital readmissions for patients in ACOs has declined. ACO Administration 2012 Who administers the ACO? HIN Accountable Care Organizations Survey May, 2012

3 July 2012 ACOs in 2012: Activity Doubles in 12 Months Page 3 Survey Highlights Staff management and buy-in is the greatest challenge faced during ACO creation, say 21 percent of respondents. Organizations have become more efficient in ACO creation: 41 percent say it took less than a year to launch the ACO, up from 25 percent in The use of electronic health records, already vigorous in 2011 at 92 percent, is now universal, with all active ACOs using this health management tool. This year s ACOs are taking patient satisfaction more seriously, with 88 percent using this metric to evaluate ACO success. This year s ACOs favor HEDIS and the Physician Quality Reporting System measures over CAHPS metrics. Program Components: One-third of ACOs have between one and 100 physicians participating. Nurse case managers are present in 95 percent of accountable care organizations. More than three-quarters 76 percent include Medicare beneficiaries in ACOs, but the number of ACOs with Medicaid participants dropped from 44 percent in 2011 to 22 percent in Beyond staff buy-in, the greatest challenges associated with ACO creation are cost (reported by 17 percent) and clinical integration (a challenge for 14 percent). Results, Reimbursement and ROI from ACOs: Following patient satisfaction, the clinical outcomes of ACO members is the metric most frequently used to evaluate ACO success. Shared savings is still the most common reimbursement used by ACOs, but its popularity has dropped from 40 percent in 2011 to 33 percent in Nine percent of respondents in ACOs report ROI between 2:1 and 3:1 from accountable care initiatives.

4 July 2012 ACOs in 2012: Activity Doubles in 12 Months Page 4 Some Early ACO Successes: Improved clinical and financial integration. Physician understanding and engagement. Higher quality and lower costs (anticipated). Some Effective ACO Tools, Workflows or Protocols: Technology-provider who understands both healthcare and IT. Intensive case management program embedded in the primary care office is the most promising program. Electronic patient profile. Case management and care stratification tools. About the Survey This second annual e-survey on Accountable Care Organizations was administered in May 2012 via the Healthcare Intelligence Network Web site at Respondents were invited to take the survey via , e-newsletter and social networking reminders throughout the month. A total of 200 healthcare companies responded to the survey. The survey asked 34 questions on accountable care organizations, with multiple responses possible on some questions. Some questions were open-ended, inviting participants to write in their responses. Not all surveys were fully completed. Survey results were compiled by the Healthcare Intelligence Network. Respondent Demographics Responses to the May 2012 Accountable Care Organizations survey were submitted by 200 organizations. Of 117 respondents identifying their organization type, 19 percent were hospitals or health systems,14 percent were health plans, 8 percent were multi-specialty physician groups, 8 percent were disease management groups, and 37 percent categorized their organization type as Other.

5 July 2012 ACOs in 2012: Activity Doubles in 12 Months Page 5 Related Resource Need more data from this survey? The Healthcare Intelligence Network has produced 2012 Healthcare Benchmarks: Accountable Care Organizations. This 60-page report, now in its second year, delivers actionable data from 200 healthcare companies that responded to HIN s second annual ACO readiness assessment conducted in May In more than 60 charts and tables, this resource documents the numerous ways in which accountable care is transforming healthcare delivery, population health management, reimbursement for care and, most importantly to this year s survey respondents, the patient experience. For more information, please visit: About the Healthcare Intelligence Network The Healthcare Intelligence Network (HIN) is an electronic publishing company providing high-quality information on the business of healthcare. In one place, healthcare executives can receive exclusive, customized upto-the minute information in five key areas: the healthcare and managed care industry, hospital and health system management, health law and regulation, behavioral healthcare and long-term care. Contact Us: Healthcare Intelligence Network 800 State Highway 71 Sea Girt, NJ Phone: (888) Fax: (732) info@hin.com Connect with HIN: