High Performance Accountable Care: Building on Success and Learning from Experience

A key provision of the Affordable Care Act is the establishment of the Medicare Shared Savings Program, which provides incentives for improved quality and efficiency to a new category of provider—the accountable care organization (ACO). The program, slated to begin in January 2012, rewards groups of providers who agree to collaborate to offer more accountable, effective, and efficient care with a share of the savings they achieve. While the prospect of participating in this initiative has generated a groundswell of interest and activity among providers, many issues need to be addressed about the methods that will be used to determine how that accountability is to be achieved, assessed, and rewarded. This report provides recommendations for ensuring the successful implementation and spread of ACOs to achieve the goals of a high performance health system. Support for this research was provided by The Commonwealth Fund. This and other Fund publications are available online at www.commonwealthfund.org. To learn more about new publications when they become available, visit the Fund’s Web site and register to receive e-mail alerts. Commonwealth Fund pub. no. 1494. THE COMMONWEALTH FUND COMMISSION ON A HIGH PERFORMANCE HEALTH SYSTEM James J. Mongan, M.D. (Chair) Professor Department of Health Care Policy Harvard Medical School Maureen Bisognano, M.Sc. President and Chief Executive Officer Institute for Healthcare Improvement Sandra Bruce, M.S. President and Chief Executive Officer Resurrection Health Care Christine K. Cassel, M.D. President and Chief Executive Officer American Board of Internal Medicine and ABIM Foundation Michael Chernew, Ph.D. Professor Department of Health Care Policy Harvard Medical School John M. Colmers, M.P.H. Vice President Health Care Transformation and Strategic Planning Johns Hopkins Medicine Patricia Gabow, M.D. Chief Executive Officer Denver Health Glenn M. Hackbarth, J.D. Consultant George C. Halvorson Chairman and Chief Executive Officer Kaiser Foundation Health Plan Inc. Jon M. Kingsdale, Ph.D. Consultant Gregory P. Poulsen, M.B.A. Senior Vice President Intermountain Health Care Neil R. Powe, M.D., M.P.H., M.B.A. Chief, Medical Services San Francisco General Hospital Constance B. Wofsy Distinguished Professor and Vice-Chair of Medicine University of California, San Francisco Louise Y. Probst, R.N., M.B.A. Executive Director St. Louis Area Business Health Coalition Martin J. Sepulveda, M.D., FACP IBM Fellow and Vice President Integrated Health Services IBM Corporation David A. Share, M.D., M.P.H. Vice President Value Partnerships Blue Cross Blue Shield of Michigan Glenn D. Steele, Jr., M.D., Ph.D. President and Chief Executive Officer Geisinger Health System Alan R. Weil, J.D., M.P.P. Executive Director National Academy for State Health Policy