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Accountable care around the world: a framework to guide reform strategies
Mark McClellan1, James Kent2, Stephen J Beales3
1Mark McClellan is chair of the Accountable Care Forum at the World Innovation Summit for Health (WISH), Qatar Foundation, and a senior fellow and director of the Health Care Innovation and Value Initiative at the Brookings Institution, in Washington, D.C.
Health Affairs (Project Hope)
|September 10, 2014
Summary
Accountable care reforms align healthcare payments with patient goals globally. A new framework assesses these reforms by focusing on population health, outcomes, and coordinated care delivery.
Area of Science:
- Health Services Research
- Healthcare Policy
- Health Economics
Background:
- Accountable care aims to align healthcare payments with patient-centered reform goals.
- Its principles are being adopted internationally, not just in the United States.
- Existing reforms require a standardized method for assessment and definition.
Purpose of the Study:
- To define accountable care systems globally.
- To propose a conceptual framework for characterizing and assessing accountable care reforms.
- To illustrate the framework's application in Spain and Singapore.
Main Methods:
- Review of international accountable care reform experiences.
- Development of a five-component conceptual framework: population, outcomes, metrics and learning, payments and incentives, and coordinated delivery.
- Application of the framework to case studies in Spain and Singapore.
Main Results:
- A globally applicable definition of an accountable care system is proposed.
- The conceptual framework provides a structure for characterizing and assessing reforms.
- The framework can map progress through different levels of reform sophistication.
- Case studies demonstrate the framework's utility in real-world implementations.
Conclusions:
- Policy makers should prioritize population health and wellness over illness treatment.
- Shifting payment models to reward outcomes rather than activities is crucial.
- Fostering collaboration and coordinated care delivery is essential.
- Promoting interoperable data systems supports effective accountable care.
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