Building ACOs and Outcome Based Contracting in the Commercial Market: Provider and Payor Perspectives, for THINC: Taconic Health Information Network and Community

In February 2011, the Taconic Health Information Network and Community (THINC) convened a workgroup (the Workgroup) to identify common ground and critical issues underlying the willingness of health plans and health care providers to collaborate in forming innovative value-based payment models. These models would parallel Medicare and Medicaid payment reform and, in particular, shared saving programs with accountable care organizations (ACOs). Such collaborations are referred to throughout this paper as "ACO-contracts" or "ACO contracting" arrangements. The Workgroup facilitated several wide ranging discussions among health plans and providers serving the Hudson Valley. These encounters have given rise to learning on a number of specific points. Perhaps more importantly, they have contributed to a framework of understanding as to the expectations, priorities and needs of the stakeholders. It is hoped that enunciating this framework will contribute to greater understanding among stakeholders as to pathways that might advance their common objectives of delivering high quality and cost-effective care.

In furtherance of this goal, Section II presents certain perspectives gleaned from health care providers and Section III attempts to depict the perspective of health plans. Section IV then draws from these some opportunities for common ground among the providers and health plans.