Summary

One growing crack in the foundation of our healthcare system is caused by the misguided incentives that reimburse care providers for individual patient visits and treatments rather than the overall improvement of patient care and wellness. To better align payers and providers, one key element of federal healthcare insurance reform is the creation of Accountable Care Organizations (ACOs), which are designed to unify a broad spectrum of care providers and establish incentives for them to work collaboratively to address patients’ overall health.

However, plans to establish ACOs frequently stall because payers and providers are struggling to agree on a program framework. L.E.K. Consulting’s new report addresses how payers and providers can establish metrics that enable all ACO partners to succeed. The report includes:

  • Seven hurdles to ACO adoption (quality metrics, incentives, governance, etc.)
  • Keys to successful collaboration between payers and providers
  • Best practices for planning next steps in ACO development
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