Providers and insurers need to do a better job of reaching patients and employers to help private accountable care organizations achieve lower costs and higher quality, according to physician executives at four large health insurance companies.
Their experiences reflect that ACOs are still a new structure, and building a new payment and care model as complex as an ACO is not easy to roll out. Dr. Alan Muney, chief medical officer at Cigna Corp., said his company has more than 130 large-group ACOs. Only 58% have both lowered costs and improved quality. Part of the problem, he said, is that so many doctors are still paid on a volume basis. Successful ACOs have tied payment to measures of quality, safety and patient satisfaction, and hospitals and doctors were on board with that.