10 top providers of ACO services
Vendors’ information technology capabilities help organizations manage contract risks.
Vendors offer crucial capabilities for organizations developing ACOs
Healthcare’s shift to value-based care has increased the interest in accountable care organizations. According to a recent report from Chilmark Research, about 936 ACOs were in operation at the end of last year, participating in more than 1,300 ACO contracts. Starting an ACO is fraught with risk—provider organizations typically may start their own, and then look for help with any technology, resource or knowledge gaps they need to fill, Chilmark says. Alternatively, a potential ACO can outsource a portion or all ACO development to a third-party vendor. The Chilmark report rates the capabilities of 10 ACO vendor “enablers,” which are capable of supporting “the complete end-to-end development, deployment, optimization and sometimes even the ongoing administration of ACOs.”
ACOs need these capabilities to address market complexity
The Chilmark report identifies three key capabilities that ACOs need to succeed, which ACO solution vendors aim to supply to developing ACOs. Many of these capabilities rely on information technology prowess.
Population Health
Electronic collaborative consumer health record
Analytics
Data sharing and interoperability
Care management
Engagement
Strategy and Business
Network design
Provider/network recruitment and training
Broad enterprise design
Legal and compliance capabilities
Systems or vendor management
Sales and marketing skills
Financial Management
Actuarial modeling
Network design
Measurement and incentive design
Provider compensation design
Cost accounting and performance monitoring
Reimbursement reconciliation acumen
What follows are Chilmark’s ratings of the three top strengths of 10 ACO enablers in achieving the capabilities listed above.
Aledade
Two years of experience and 15 ACOs
https://www.aledade.com/
Differentiators:
Gives PCPs an alternative to remain independent
Has policy, regulatory and population health management expertise
Requires no work on the provider’s end to build the ACO
Caravan Health
Three years of experience and 23 ACOs
http://caravanhealth.com/
Differentiators:
Offers rural providers a first-to-market advantage
Has experience and trust in the market segment
Offers a track record in which one-third of its ACOs received shared savings in the first year
CHESS
Four years of experience and 3 ACOs
http://www.chessmso.com/
Differentiators:
Has relevant experience working in this model
Offers flexible and customizable solutions
Has deep contracting expertise
Conifer Health
Five years of experience and 11 ACOs
http://coniferhealth.com/
Differentiators:
Has 20 years of experience with all types of value-based arrangements
Offers expertise across a variety of payment models
Has strengths in being clinically driven with a focus on clinical outcomes and measurement
Cognizant
Experience level and number of ACOs not disclosed
https://www.cognizant.com/healthcare
Differentiators:
Offers a proprietary implementation framework
Has a breadth and depth of experience in supporting providers
Supplies advanced data warehousing and analytics capabilities
Evolent
Four years of experience and 10 ACOs
https://www.evolenthealth.com/
Differentiators:
Assumes a portion or 100 percent of downside risk
Has vast experience, which enables turnkey implementations
Consistently has results generating shared savings
McKesson
Five years of experience and 13 ACOs
http://www.mckesson.com/
Differentiators:
Has consulting expertise along the entire VBC lifecycle
Offers years of experience in VBC enablement
Can educate providers on how best to use information technology
Optum
Five years of experience and an undisclosed number of ACOs
https://www.optum.com/
Differentiators:
Has size and breadth of consulting experience
Offers IT and services experience
Provides strong financial analysis and actuarial support, along with VBC/ACO experience running their own ACOs
Premier
Four years of experience and 68 ACOs
https://www.premierinc.com/
Differentiators:
Has extensive VBC experience and knowledge
Offers deep staff expertise (60 SMEs with decades of experience)
Draws upon a market leadership position that sets the pace for VBC
TMA Practice Edge
One year of experience with 12 ACOs
http://www.tmapracticeedge.com/
Differentiators:
Works with physicians in Texas to support their independence
Develops 100 percent physician-owned networks with TMA support
Brings scale to small practices, with 80 percent having only one or two primary care physicians