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Accountable Care News: Thought Leaders’ Corner

Accountable Care News: October 2015, Thought Leaders’ Corner

Accountable Care News approached Bill Eggbeer, Managing Director with BDC Advisors, to discuss: Will the creation of “product-based” ACOs &mdash an insurance product partnership between a health plan and a respected Accountable Care Organization — become a new trend going forward?

Bill Eggbeer responded:

“Certainly, particularly with narrow network products. Preferred product partnerships between health plans and provider systems are being tested in a number of states to bring narrow network offerings to the Health Insurance Exchanges. A narrower, coordinated care network with lower prices is preferred by patients over expanded choice of providers, and ACOs are well positioned to participate in these offerings.

What is equally likely is that major employers such Boeing, Lowe’s, and Walmart will develop their own direct multi-year relationships with ACOs as they look for predictable costs, and high quality customer service. The Boeing Corporation offers its Preferred Partnership’ ACO option to its employees and retirees in Washington state exclusively with the Providence-Swedish Health Alliance ACO, and the University of Washington Medicine Accountable Care Network.

The management of risk is transferred from the insurance carrier to the ACO. The carrier’s role is redesigned to focus on claims processing and administrative services. If the ACO fails to meet the cost targets, they pay the difference, and if they fail to meet service level requirements, there are financial penalties. Of course, if they beat the target they reap the value saved. Here comes the future!”


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