How England's Clinical Commissioning Groups Could Help America's ACOs

The United States is not the only major developed country going through a period of healthcare reform. The United Kingdom is as well, and it has high ambitions of saving $2 billion every year.

England's National Health Service Chief Executive Sir David Nicholson challenged the health system to find up to $30 billion in efficiency savings by 2015. At the epicenter of this reform effort are clinical commissioning groups, which are the subject of a new whitepaper from healthcare analytics firm MedeAnalytics.

Ken Perez, senior vice president of marketing and director of healthcare policy for MedeAnalytics, said England's CCGs are somewhat similar to commercial accountable care organizations in the United States. CCGs aim to spend less money in the acute-care setting, make small changes to improve preventive care, encourage clinical best practices in care delivery and reward innovations that reduce costs and/or improve outcomes.

For the study, analysts looked at eight primary metrics within England's 212 CCGs:

•    Emergency admissions with 0-1 day length of stay
•    Inappropriate admissions
•    Readmissions within 30 days
•    Outpatient procedures carried out as inpatient same-day procedures
•    Follow-up outpatients to first outpatients visits ratio
•    Walk-in/inappropriate accident and emergency visits during general practitioner clinic hours
•    Admissions for long-term conditions
•    Falls

The study's authors found that if every CCG achieved an average performance level for those eight metrics, England-based hospitals could save $1.3 billion. Further, if CCGs achieved the top levels of performance in patient management of those eight metrics, savings could exceed $2 billion.

"In rounded dollar terms, the U.K. healthcare system could save $2 billion annually, and this could have implications for our nation, as we so urgently need to find viable paths to substantive savings, especially given the lack of many ACO cost-saving success stories," Mr. Perez said in a statement.

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