10 Major Findings on ACOs: Most Common Patient Populations, Reimbursement and Leadership Models

How are today's accountable care organizations led and reimbursed? How many lives do they cover and what are the most common types of patient populations? What challenges do they face, and how long does it take, on average, to create an ACO?

Data from Healthcare Intelligence Network's "2012 Healthcare Benchmarks: Accountable Care Organizations" aims to answer these questions.

The survey was administered electronically in May 2012. A total of 200 healthcare organizations responded to the survey, including health systems, health plans, multispecialty physician groups and disease management groups.

Here are 10 of the survey's major findings.

• Of the respondents, 30.5 percent were participating in an ACO.

• Of those participating ACOs, 51.2 percent were part of CMS' Medicare Shared Savings program.

• Of the respondents participating in an ACO, 24.4 percent were physician-led whereas 4.9 percent were hospital-led. Health plans led roughly 20 percent, and physician-hospital organizations led 15 percent.

• The most common populations in the surveyed ACOs are Medicare patients (75.7 percent), commercially insured patients (54.1 percent) and Medicaid patients (21.6 percent).

• Nearly half (48.6 percent) of the ACOs covered 10,000 lives or more.

• Most ACOs in the survey had no more than 100 physicians (32.5 percent). ACOs with 101 to 500 physicians (27.5 percent) and 1,001 to 5,000 physicians (20 percent) were the next most common sizes.

• Forty percent of ACOs were created in less than a year, and 32.4 percent were created in one year to 18 months. It took 5 percent of respondents in the survey more than two years to create an ACO.

• Thirty-three percent of ACOs use shared savings, making it the most common reimbursement model.

• Staff and management buy-in was the most common challenge to ACO creation (20.7 percent) followed by cost (17.2 percent). Evidence-based care delivery was the least cited challenge (0 percent).

• Roughly 36 percent of respondents didn't know their ACO's return on investment whereas 51.5 percent said it is too early to tell. Nine percent of ACOs said it is between 2:1 and 3:1.

More Articles on ACOs:

Survey: 50% of Hospitals Say They Have Financial Strength to Accept ACO Risk
The New Competitive Edge for Hospitals and ACOs: Employee Health
7 States Establishing Medicaid ACOs


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