Doug Hastings Speaks On Role Of ACOs In Improving Health Care

AHIP HI-WIRE

Doug Hastings, a Member of the Firm in the Washington, DC office, was quoted on AHIP HI-WIRE, a health-industry news provider, on the role that accountable care organizations (ACOs) can play in increasing the quality of health care delivery in the United States.

The article, "ACOs: Building Blocks For Providing Health Care Value," reported Hastings' remarks, which were made at the America's Health Insurance Plans (AHIP) 2010 National Policy Forum. Hastings presented a talk titled "Can Accountable Care Organizations Improve the Value of Health Care by Solving the Cost and Quality Conundrum?"

Hastings defined an ACO as any organization that can provide health care in a timely manner through better coordination, transparency to consumers and quality standards. He noted there is a spectrum of integration among providers, based on the number of providers involved and the level of integration. The level of integration typically deepens over time. But he cautioned that ACOs by themselves do not address cost pressures, which require a different payment model not only a different care-delivery model.

Hastings pointed out that payment models also exist on a spectrum. At the least desirable end is the fee-for-service model, by which a payment is made for each individual action a provider takes. He stressed that fee-for-service can be improved by creating larger bundles of payments. As bundles get bigger, the incentives increase for care providers to make sure that their patients not only get healthy, but stay healthy.

The transition to ACOs can happen in the three to five years, said Hastings, who added that the private sector cannot rely solely on federal leadership through Medicare and Medicaid.