Almost 10 percent of U.S. patients receive their healthcare from an ACO, and almost half live in areas served by at least one ACO, according to a new study from Oliver Wyman.
This means that ACOs have significantly grown in the last two years, and are poised to offer a competitive threat to traditional FFS medicine, the report states.
A total of 25 to 31 million U.S. patients currently receive their care through ACOs. They include:
- 2.4 million patients in Medicare ACO programs
- 15 million non-Medicare patients in Medicare-oriented ACOs
- 8 to 14 million patients in non-Medicare ACOs.
The study also found that roughly 45 percent of the population live in regions served by at least one ACO. While relatively few organizations have achieved the full potential of the model, the top performers are already generating savings and delivering improved care, researchers state.
Researchers analzyed primary care service areas (PCSAs), or areas generally larger than zip codes and smaller than counties, and defined by where residents get their primary care. The Boston and Los Angeles metropolitan areas have a high number of residents in PCSAs served by ACOs. as does Texas. In total, there are 19 states where more than half of the population lives in a PCSA served by at least one ACO.
While many of the organizations studied are ACOs in name only, researchers suggest that critics look at the spread of the new model and the performance of the best-in-class. One California ACO had a zero percent premium increase its first year, something very few are able to achieve. As more and more ACOs learn to make the model work, they have the potential to change the whole dynamic of U.S. healthcare for the better, the report states.
Source: Oliver Wyman, November 29, 2012
This 57-page special report offers snapshots of thriving medical home initiatives and their particular area of focus. Details on the following are also provided: organizational motivation for pursuing medical home recognition; the challenges of physician engagement; and reengineered staffing and workflows that are transforming care coordination.