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Accountable Care in Early Stage Development around the Globe

September 9, 2014
by Gabriel Perna
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Accountable care programs and initiatives are forming across the globe, but most are still in the early stages of development, a new research article reveals.

Researchers for the article developed a framework for characterizing and assessing reform in accountable care. They then took this framework, which consists of population, outcomes, metrics and learning, payments and incentives, and coordinated delivery, and looked at examples of accountable care initiatives across the world and how they aligned with this framework.

In Spain, an accountable care model has reduced costs by 75 percent per resident in Valencia and improved outcomes through lower readmission rates, while reducing waiting times. In Singapore, elderly patients are assigned to two accountable care initiatives through the use of EHRs. Readmission rates have gone down by 40 percent for one group and another group has halved the number of emergency visits among its population. Savings in the program is estimated at U.S. $11 million.

In the eyes of the authors, a collection of researchers from the Qatar Foundation, Boston Consulting Group, Imperial College London, Primary Health Corporation, and Brookings Institution, there is enough evidence to suggest accountable care can succeed in improving the quality of care in a variety of settings. Not enough evidence suggests that there are cost-savings from these programs over the long-term, the researchers say. They cite several reasons for the delay in cost savings, including high transaction fees in the early stages of development.

At the end of the article, the authors include suggestions for policy makers to spur the growth of accountable care initiatives. This includes applying episode-based models for measuring quality, outcomes, and resource use for high-impact diseases; creating a favorable environment for collaboration; and encouraging the adoption of interoperable systems.

“To achieve clinically integrated care and help stratify the patient population by risk category, it is essential that information systems allow multiple providers and patients to share data and access them in real time,” the authors write in the study.

The research was published in a recent issue of Health Affairs.

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