Find value in innovation

3 ways payer-led ACOs achieve the triple aim

By Dori Zweig

Creativity gets the juices flowing. And creative innovations--particularly when it comes to ACO payment models--can ensure success.

Take, for example, Blue Cross Blue Shield of Massachusetts (BCBSMA). The insurer found success with its version of a global payment system, or alternative quality contract (AQC). In fact, it worked so well that the Centers for Medicare & Medicaid Services incorporated this model into the features of the Pioneer ACO program.

The idea stemmed from a question: "Why do healthcare costs increase so much faster than everything else we buy?" This symmetrical model aims to slow the growth rate of total medical claims spending--it also shares in savings as well as shares in deficits, BCBSMA Senior Vice President of Performance Measurement and Improvement, Dana Gelb Safran, Sc.D.,(pictured right) previously told FierceHealthPayer.

What's more, from a payer standpoint, it's important to think differently. Insurer-led ACOs should launch new reimbursement methods with early adopters, or doctors, who are willing to try new things and see value in innovations, Shaun Frost, associate medical director of care delivery system for HealthPartners Health Plan in Minnesota, said at the AHIP Institute 2014 in Seattle.

And of course, it's important to be flexible. Frost recommended insurers be willing to customize options to give doctors several reimbursement choices and operate different payment models simultaneously.

Creating innovative payment models can and will help reduce healthcare spending.