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Strategic Partnerships Help Health Care Organizations Transition Toward ACO Model

Stacy Clapp

November 2012
Organizational Options

Health care institutions are increasingly pressured to provide quality patient care at a lower cost. While the Obama administration has proposed accountable care organizations (ACOs) as a potential vehicle for reaching those goals, jumping directly from a predominantly fee-for-service model to a full-fledged ACO is not always feasible. Some health care organizations are experimenting with their own transitional models of shared accountability, including partnerships with other health care organizations to pool their resources. “When doctors and other health care providers can work together to coordinate patient care, patients receive higher quality care, and we all see lower costs,” according to the Centers for Medicare & Medicaid Services (CMS). In theory, such partnerships would streamline access to patient information and lead to better patient care coordination.

Inova Health System, a not-for-profit health care system based in Falls Church, Va., will soon be putting this theory to the test. In June 2012, Inova partnered with Aetna, a major national health care benefits provider based in Hartford, Conn., to establish Innovation Health Plans, a jointly owned health plan serving Northern Virginia, including more than 1.1 million residents currently served by Inova. The new co-branded health insurance plan is a separate corporate entity from either corporation that will be licensed first in Virginia as a preferred provider organization and also as a health maintenance organization. It is scheduled to roll out starting on January 1, 2013.

Pooling Assets
“This is the opportunity for a major provider system and insurer to get together and do some things that haven’t been done before,” says Kylanne Green, Inova’s executive president of health services. While not considered a CMS/Medicare ACO in the strict legal sense, Innovation Health Plans aims to hold members more accountable for care ....

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