Paths to Sustainability for Innovative Delivery System Programs

Peter Hussey, Courtney Armstrong, and Eric Schneider of the RAND Corporation conducted interviews with seven health plans and five Accountable Care Organizations (ACOs) to determine their support for innovative delivery system models including payment arrangements, program development strategies, and the criteria decide whether or not to support these programs. All interviewees are currently engaged in innovative care delivery efforts aimed at improving quality and reducing the cost of healthcare and believe that the current payment system has not moved far enough away from fee-for-service to support meaningful delivery system changes. The report suggests that a shift towards alternative payment methodologies, an alignment of incentives across payers, and a better understanding of the impact of care delivery transformation are all necessary to achieve sustainability. The authors find that the main challenge in innovation will building capacity and managing financial risk, particularly for smaller and less-experienced provider organizations.

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