Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

4 Fresh Accountable Care Organization Growth Predictions

“In the immediate future, the growth of the ACO movement will depend most heavily on the success of current ACOs."

A new year calls for new accountable care organization (ACO) reflections. What is the new ACO future?

Accountable care organizations provider risk

Healthcare providers remain focused on collecting financial bonuses and achieving subsequent revenue cycle and ROI success.

But numerous risk and alignment challenges mean ACOs may not always be a viable revenue cycle management solution.

The alleged popularity of low-risk ACOs is holding strong and steady at the start of 2016.

Between 105 and 176 million patients may be covered via an ACO by 2020, according to a recent report from Leavitt Partners which explains new growth predictions on possible baseline scenarios and ACO analysis.

ACOs have reportedly increased in size by almost 400 percent over the past 3 years – from 157 in March of 2012 to 782 last December, says the report.

Twenty-three million lives are covered by ACOs as of only last month, Leavitt Partners confirms.

“Value-based care delivery models designed to improve the financial and quality outcomes of health care organizations have been the focus of the health care discussion for several years,” writes Leavitt Partners.

“For the last several years, [ACOs] have grown rapidly as a model of paying for and delivering health care. Despite this momentum, the future of the model remains uncertain.”

Primary whitepaper findings consider predictions of ACO success

Recent ACO success dictates future ACO growth estimates, says the report. Levels of financial risk will be shaped by upcoming federal and state government incentives and penalties, Leavitt Partners adds.

The federal government has demonstrated clear support of the ACO model, which will prolong and accelerate the growth of the accountable care model,” the organization writes. “The model is still relatively new, and the early results from ACOs have not been consistently positive.”

Future support initiatives will thrive as new ACO programs – including the Next Generation ACO model, the Comprehensive ESRD Care program, and the Oncology Care Model – blossom further, says Leavitt Partners.

Beneficial financial outcomes are nonetheless predicted to grow. Leavitt Partners surmises the meager number of ACOs earning bonuses will increase in due time.

4 key drivers of ACO growth to consider

Leavitt Partners points to 4 specific factors that may clearly shape the early evolution and maturity of the ACO domain:

  • Altruism: The belief that accountable care represents a better way of delivering care.
  • Experimentation: The use of accountable care as a preparatory model for more advanced models of provider risk-bearing.
  • Expansion: The use of accountable care as a strategy to increase market share.
  • Defense: The use of accountable care as a response to risk-bearing approaches by market competitors and/or an inability to stay competitive with traditional payments.

Leavitt Partners asserts healthcare providers may exceed 176 million – over half of the national population – within the next 5 years if public and private payer support remains zealous.

“In the immediate future, the growth of the ACO movement will depend most heavily on the success of current ACOs. Providers who are considering accountable care with hesitation will be most strongly influenced by the success or failure of organizations currently involved in accountable care.”

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