ACO ser­vice in­dus­try blooms

Modern Healthcare - - THE WEEK IN HEALTHCARE - Melanie Evans

Arocky start to Medi­care’s ap­proach to ac­count­able care has done lit­tle to de­ter com­pa­nies ea­ger to mar­ket an­cil­lary ser­vices and prod­ucts to hos­pi­tals and med­i­cal groups.

The Univer­sity of Pittsburgh Med­i­cal Cen­ter’s health plan and the Ad­vi­sory Board, a con­sult­ing com­pany, an­nounced a joint ven­ture last week to mar­ket ac­count­able care tech­nol­ogy and out­sourc­ing ser­vices. In Min­nesota, mean­while, spe­cialty ben­e­fit un­der­writ­ers the Star Line Group, in­sur­ance bro­kers U.S. Ad­vi­sors and con­sul­tants As­cen­dant Care said they would sell rein­sur­ance to ac­count­able care or­ga­ni­za­tions in the Medi­care shared sav­ings pro­gram.

And one of the third quar­ters’ largest ven­ture cap­i­tal in­vest­ments was the $70 mil­lion raised by Essence Group Hold­ings Corp. for its ac­count­able-care soft­ware and ser­vices sub­sidiary.

The fed­eral push to pro­mote ac­count­able care re­ceived a boost in Oc­to­ber when of­fi­cials over­hauled an ini­tial Medi­care pro­posal that many in health­care re­jected (Oct. 24, p. 6). Re­newed in­ter­est in Medi­care’s pro­gram for ACOS has added to mo­men­tum be­hind the largely untested pay­ment model in pri­vate mar­kets, where com­mer­cial in­sur­ers, hos­pi­tals and med­i­cal groups have an­nounced their own ef­forts.

“You’re re­ally see­ing a lot of move­ment,” thanks to the fed­eral ini­tia­tive, in­sur­ance con­tracts that shift more fi­nan­cial risk to providers, and merg­ers and ac­qui­si­tions be­tween health plans and health sys­tems, said Diane Holder, pres­i­dent and CEO of UPMC Health Plan. “I am not sure where it’s all go­ing,” she said, call­ing the ac­tiv­ity “in­ter­est­ing.”

Ac­count­able care of­fers hos­pi­tals, med­i­cal groups and other health­care providers fi­nan­cial in­cen­tives to reach qual­ity and cost-con­trol goals for a group of pa­tients. Un­der Medi­care ac­count­able care, which is sched­uled to be­gin next year, hos­pi­tals and doc­tors can earn a

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