31.5% Would Estimate Accountable Care Organizations Currently Have a Material Impact in Their Marketplace

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1 31.5% Would Estimate Accountable Care Organizations Currently Have a Material Impact in Their Marketplace Stakeholder survey on progress of and insights into accountable care organizations MODESTO CA, January, MCOL and Accountable Care News jointly sponsored the fifth annual survey of healthcare professionals, during December, on their involvement with and their insights regarding accountable care organizations. An exclusive report on the survey findings follows. Participants were asked to respond to seven items: 1. Please indicate your perspective. Provider (Hospital, Physician, Pharmaceutical, Other) Purchaser (Health Plan, Employer, TPA, Agent, PBM) Vendor or Other 2. Is your organization involved with ACOsincluding development, operation, or contracting arrangements? 3. When would you estimate ACOs would have a material impact in your marketplace? 4. If ACO Medicare pilots are not ultimately successful, will that cause commercial and Medicaid ACO arrangements to generally fail as well? 5. How confident are you that ACOs will actually generate the necessary savings? 6. Will bundled payments prove to be a more effective delivery and payment reform model than ACOs? 7. If you could only pick one, what would be the most important part of the Medicare ACO rules to change? Executive Summary: For the fifth year in a row, the vast majority (83.3%) of respondents said their organizations are involved with ACOs, including development, operation, or contracting arrangements. Vendors (or others) were the most likely respondent category to say their organization was involved with ACOs at 88.2%, which was only slightly more than providers at 85.2% and purchasers at 66.7%. (see Chart 1) Chart No Blue = Provider Red = Purchaser Green = Vendor/Other Yes The amount of respondents who said that ACOs currently have a material impact in the marketplace has gradually increased, since this question was first asked in % of respondents in this year s survey thought ACOs currently have an impact. 3.7% of respondents believe ACOs will have never had an impact at all. MCOL Accountable Care epoll Dec

2 20.4% think that ACOs either currently do have, or will have, in 2015, an impact in the marketplace.13. of respondents think that ACOs will have a material impact in 2016 while 22.2% think they will sometime from 2017 to (see Chart 2) Chart Chart Blue = Provider Red = Purchaser Green = Vendor/Other No Unsure Yes Those in the purchaser category had the most optimistic outlook of ACO impact on the marketplace with 55.6% saying that ACOs either currently do have, or will have, in 2015, an impact. Vendor (or others) and providers were far behind, with (23.5% and 29.6%, respectively) of each group having the same optimism. No respondents in the provider category said ACOs will never have an impact on the marketplace while 11.1% of purchasers and 5.9% of vendor (or others) said they never would. A minority of respondents (27.8%) think that if ACO Medicare pilots are not ultimately successful, that will cause commercial and Medicaid ACO arrangements to generally fail as well. A plurality (50.) disagree with this statement. Less than a quarter of respondents (22.2%) were unsure whether or not this statement was true. Vendors (or others) were mostly in agreement (58.8%) that the successes of ACO Medicare pilots were not tied to the success of commercial and Medicaid ACO arrangements. Purchasers, providers, and vendor/others both had under 3 of respondents that Medicare s success was tied to Medicaid s and Commercial s. (see Chart 3) MCOL Accountable Care epoll Dec A portion of respondents (38.9%) are confident that ACOs will actually generate the necessary savings. 20.4% are neutral about it, 18.5% are doubtful about it, and 14.8% are very doubtful regarding this matter. Provider and Purchaser categories tied with 44.4% in regards to being confident that ACOs will actually generate the necessary savings. (see Chart 4) Chart The total numbers of respondents (46.3%) neutral on whether bundled payments prove to be a more effective delivery and payment reform model than ACOs. 24.1% disagreed with this, and 16.7% agreed. Only a small amount of respondents on both sides felt strongly about their position, with only 5.6% strongly disagreeing and 7.4% strongly agreeing.

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4 Providers (25.9%) leaned to disagree while purchasers (22.2%) leaned to agree. Purchasers and vendors/other were similar in neutrality at 55.6% and 52.9%, respectively. (see Chart 5) Chart Agree Disagree Neutral Strongly Agree Strongly Disagree 40.7% of respondents say that patient attribution would be the most important part of the Medicare ACO rules to change. Providers are split between metrics and data/risk vs. reward at 25.9%. Vendor (or other) are also split metrics and data/risk vs. reward at 29.4%. And the majority of purchasers would choose metrics and data to the most important part of the Medicare ACO rules to change (66.7%). (see Chart 6) Chart Metrics and Data Patient Attribution Risk vs. Reward Blue = Provider Red = Purchaser Green = Vendor/Other MCOL Accountable Care epoll Dec

5 Tables Is your organization involved with ACOs- including development, operation, or contracting arrangements? No 14.8% 33.3% 11.8% 16.7% Yes 85.2% 66.7% 88.2% 83.3% Total When would you estimate ACOs would have a material impact in your marketplace: % 11.1% 23.5% 20.4% % 11.1% 17.6% % 11.1% 17.6% 22.2% Currently Do 29.6% 55.6% 23.5% 31.5% Never % 5.9% 3.7% Unsure 7.4% % 9.3% Total If ACO Medicare pilots are not ultimately successful, will that cause commercial and Medicaid ACO arrangements to generally fail as well? No 48.1% 44.4% 58.8% 50. Unsure 25.9% 33.3% 11.8% 22.2% Yes 25.9% 22.2% 29.4% 27.8% Total How confident are you that ACOs will actually generate the necessary savings? Confident 44.4% 44.4% 29.4% 38.9% Doubtful 11.1% 33.3% 23.5% 18.5% Neutral 14.8% 11.1% 35.3% 20.4% Very Confident 11.1% 11.1% % Very Doubtful 18.5% % 14.8% Total Will bundled payments prove to be a more effective delivery and payment reform model than ACOs? Agree 14.8% 22.2% 17.6% 16.7% Disagree 25.9% 11.1% 23.5% 24.1% Neutral 40.7% 55.6% 52.9% 46.3% Strongly Agree 7.4% 11.1% 5.9% 7.4% Strongly Disagree 11.1% % Total MCOL Accountable Care epoll Dec

6 If you could only pick one, what would be the most important part of the Medicare ACO rules to change? Metrics and Data 25.9% 66.7% 29.4% 35.2% Patient Attribution 48.1% 22.2% 41.2% 40.7% Risk vs. Reward 25.9% 11.1% 29.4% 24.1% Total Historical Comparison to Previous epolls If ACO Medicare pilots are not ultimately successful, will that cause commercial and Medicaid ACO arrangements to generally fail as well? Yes % No 22.2% 48.5% Unsure 27.8% 26.3% Total How confident are you that ACOs will actually generate the necessary savings? Confident 38.9% 10.1% 10.9 Doubtful 18.5% 25.3% 20.9 Neutral 20.4% 32.3% 28.2 Very Confident 7.4% 29.3% 35.5 Very Doubtful 14.8% Total Will bundled payments prove to be a more effective delivery and payment reform model than ACOs? Agree 16.7% 6.1% 11.8 Disagree 24.1% 23.5% 23.6 Neutral 46.3% 37.8% 33.6 Strongly Agree 7.4% 30.6% 25.5 Strongly Disagree 5.6% Total MCOL Accountable Care epoll Dec