New Analysis Describes Seven Types of Accountable Care Payment Models
WASHINGTON (June 21, 2016) – A new report from the Health Care Transformation Task Force, a consortium of patients, payers, providers and purchasers working to transform the U.S. health care delivery system, offers a comprehensive look at the seven predominant payment models currently used by accountable care organizations.
“There’s no ‘one size fits all’ accountable care model that will best serve all organizations in all markets,” said Jeff Micklos, executive director of the Task Force. “Decisions about which accountable care model to employ is very fact-specific, with a focus on targeted patient population, relationships between providers and payers, market dynamics, and the goals that the ACO seeks to achieve. This paper is a resource for organizations seeking to better understand accountable care payment arrangements to determine which model is best-suited for them.”
The paper classifies seven different accountable care payment models:
- One-sided risk on total cost of care;
- At-risk care management payments;
- Two-sided risk on total cost of care;
- Capitation on limited cost of care;
- Capitation on limited cost of care with one-sided risk on total cost of care;
- Capitation on limited cost of care with two-sided risk on total cost of care; and,
- Capitation on total cost of care.
The paper describes each type of payment arrangement, notes which types of payers and provider organizations use it and outlines the level of risk transfer, as well as the opportunities and challenges unique to each arrangement.
The Task Force includes six of the nation’s top 15 health systems and four of the top 25 health insurers, as well as leading national organizations representing employers, patients and their families.
About Health Care Transformation Task Force
Health Care Transformation Task Force is a unique collaboration of patients, payers, providers and purchasers working to lead a sweeping transformation of the health care system. By transitioning to value-based models that support the Triple Aim of better health, better care and lower costs, the Task Force is committed to accelerating the transformation to value in health care. To learn more, visit www.hcttf.org.