The basic concept is simple: if a physician network/ACO can successfully manage the health of its overall patient population, achieve better clinical outcomes, and reduce total health care spending, patients fare better and physicians share in the cost savings.
The challenge is quantitatively proving that your actions are responsible for creating these savings. Independent physicians need assistance with the expertise, resources, and technology backbone needed to negotiate value-based contracts and prove clinical and financial accountability.
Some experts estimate that within 10 years, 80 percent of patient services will be rendered on value-based contracts. In Jan. 2015, the U.S. Department of Health and Human Services released new projections of future reimbursement in new payment models. Value-based care is targeted to comprise more than 50 percent of payments by 2018 (see " Your Guide to Medicare Value-based Care" to learn more).
A 2014 TMA physician survey found that roughly two-thirds of Texas physicians care for patients at independent practices. Most of these physicians don’t have access to the tools and financial support needed to transition to value-based care, forcing many to align themselves with hospital systems, though they may not want to.
Return to Accountable Care
Last Updated On
June 28, 2022
Originally Published On
April 01, 2016