Hospital C-Suite Survey Projects ACO Participation to Double in 2014

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  • Previous growth slower than originally forecasted even though ACO adoption quadrupled over the last 18 months, according to Premier, Inc. survey
  • Providers developing core ACO capabilities, including partnerships with payers and employers, investments in IT

CHARLOTTE, N.C., Dec. 18, 2013 (GLOBE NEWSWIRE) -- Hospital participation in accountable care organizations (ACOs) is projected to double in 2014, according to Premier, Inc.'s (Nasdaq:PINC) fall 2013 Economic Outlook C-suite survey.

More than 18 percent of 115 senior executive respondents – primarily CEOs (43.5 percent), chief financial officers and chief operating officers – across 35 states say their hospitals currently participate in an ACO, up from 4.8 percent in spring 2012. This growth is projected to accelerate, with about 50 percent of respondents suggesting their hospitals will participate in an ACO by the end of 2014. Overall, 76.5 percent of respondents say their hospital does or will participate in an ACO.

The pace of ACO adoption has been slower than originally anticipated by senior executives surveyed 18 months ago. Though 51.8 percent of executives predicted in the spring of 2012 that their systems would create or join an ACO by the end of 2013, results show that only 23.5 percent will likely meet that projection.

"The ACO transition is challenging for all providers, and it involves taking significant risks," said Wes Champion, senior vice president, Premier Performance Partners. "It's understandable and appropriate that some providers have been more deliberate and cautious about when they participate in an ACO. And it's clear that many are now prepared to proceed."

Survey results also suggest:

  • Non-rural hospitals are most likely to participate in an ACO overall, followed by hospitals in integrated delivery networks (IDNs).
  • Though they're equally as likely to eventually participate in an ACO, large hospitals are moving more quickly toward participation while small hospitals require additional time.
  • Rural hospitals are least likely to participate in an ACO overall, followed by stand-alone hospitals.

Population health management partnerships, investments

According to survey results, the majority of health systems are developing partnerships and making investments in the infrastructure necessary to better manage population health.

Among investments:

  • Lifestyle and wellness coaching was most often cited overall by 71.6 percent of hospital executives.
  • Almost half of rural hospitals use virtual care or telemedicine to connect with patients, compared to 1 in 3 non-rural hospitals.
  • Patient-centered medical homes are also popular for non-rural hospitals, large hospitals and hospitals in an IDN.

Respondents cited partnerships with internal physicians and provider leadership most often. Partnerships with large local employers are also popular across all types of providers (51 percent).

"Coordinating care and delivering more efficient care has been a passion at Aurora for years," said Richard Klein, executive vice president, Enterprise Business Group, Aurora Health Care (Milwaukee, Wis.), a 15-hospital system serving more than 1.2 million annually throughout eastern Wisconsin and northern Illinois. "As a self-insured employer, we've been diligently working on this with our own employees for 15 years. Now, we've built an organization that is integrated, highly efficient and is able to produce a better result for the patient."

Data, data, data

Access to integrated data with sophisticated population health status measurement is important to ACO formation. According to respondents:

  • 72.5 percent are integrating clinical and claims data to better manage population health.
  • 50 percent are using predictive analytics to forecast patient/population needs.
  • 46.3 percent are using an integrated data solution to reduce silos.

"Within our organization, clinical teams will always serve as the 'backbone' to the challenging work around population health," said Michael P. Jeremiah, MD, FAAFP, chair of the Department of Family and Community Medicine at Carilion Clinic (Roanoke, Va.), which cares for nearly 1 million residents across 18 counties in western Virginia through its eight hospitals, primary and specialty physician practices, and other services. "But IT and health analytics provide the 'nervous system' that allow us to fully function and achieve optimal patient experiences and outcomes while controlling cost."

Payer partnerships and arrangements

Survey respondents are exploring new population health partnerships with private (46.2 percent) and public (40.4 percent) payers. Among these partnerships, upside-only shared savings was the most often cited arrangement (58 percent). In this model, key care management programs are established to manage high-risk and chronically ill populations using claims analytics to predict outcomes. Savings that accrue are split equally between insurers and providers, with no penalties for failure to achieve the goals.

"Providers are building the infrastructure and core capabilities essential to ACO formation, whether or not they're in an ACO," Champion said. "This implies a new wave of ACO participants will likely emerge in future years as these partnerships mature."

In late November Premier was designated by the global research firm KLAS as an early leader in population health management for its population health portfolio. The Premier suite includes:

  • PACT™ Population Health Collaborative, helping providers improve the health status and care experience of their populations.
  • PopulationAdvisor™ population health suite, designed to improve wellness and reduce costs by coordinating care, engaging patients, and pinpointing quality and cost drivers.

About the Economic Outlook

Premier's Economic Outlook highlights emerging economic and industry trends impacting alliance members and the overall industry. The publication leverages subject matter expertise to build consensus from diverse points of view while highlighting best practices and strategies needed to drive performance improvement.

About Premier, Inc.

Premier, Inc. (Nasdaq:PINC) is a leading healthcare improvement company, uniting an alliance of more than 2,900 U.S. hospitals and nearly 100,000 other providers to transform healthcare. With integrated data and analytics, collaboratives, supply chain solutions, and advisory and other services, Premier enables better care and outcomes at a lower cost. Premier, a Malcolm Baldrige National Quality Award recipient, plays a critical role in the rapidly evolving healthcare industry, collaborating with members to co-develop long-term innovations that reinvent and improve the way care is delivered to patients nationwide. Headquartered in Charlotte, N.C., Premier is passionate about transforming American healthcare. Please visit Premier's news and investor sites on; as well as Twitter, Facebook, LinkedIn, YouTube, Instagram, Foursquare and Premier's blog for more information about the company.

Forward-looking statements

Statements made in this release that are not statements of historical or current facts, such as the expected growth in ACO participation by hospitals, and the development of partnerships or collaborations by hospitals and future investments by hospitals in the infrastructure necessary to better manage population health, described herein, are "forward-looking statements" within the meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements may involve known and unknown risks, uncertainties and other factors that may cause the actual results, performance or achievements of Premier to be materially different from historical results or from any future results or projections expressed or implied by such forward-looking statements. Accordingly, readers should not place undue reliance on any forward looking statements. In addition to statements that explicitly describe such risks and uncertainties, readers are urged to consider statements in the conditional or future tenses or that include terms such as "believes," "belief," "expects," "estimates," "intends," "anticipates" or "plans" to be uncertain and forward-looking. Forward-looking statements may include comments as to Premier's beliefs and expectations as to future events and trends affecting its business and are necessarily subject to uncertainties, many of which are outside Premier's control. More information on potential factors that could affect Premier's financial results is included from time to time in the "Forward Looking Statements," "Risk Factors" and "Management's Discussion and Analysis of Financial Condition and Results of Operations" sections of Premier's periodic and current filings with the SEC, as well as those discussed under the "Risk Factors" and "Forward Looking Statements" section of Premier's IPO Prospectus, dated September 25, 2013, filed with the SEC and available on Premier's website at Forward looking statements speak only as of the date they are made. Premier undertakes no obligation to publicly update or revise any forward-looking statements, whether as a result of new information, future events or otherwise that occur after that date.

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Source:Premier, Inc.