Reforming Provider Payment: Moving Toward Accountability for Quality and Value

As Congress and the Obama administration begin to push for health care reform, they will have to address realigning provider payment incentives to drive changes in the way health care is delivered in the United States. One such concept that could help do this is the Brookings-Dartmouth proposal for Accountable Care Organizations (ACO).

A policy forum on March 11 at the Brookings Institution focused on the need for payment reform and, specifically, the ACO model. This model provides a framework for increased accountability accompanied by new financial support for better ways of delivering care. ACOs work by organizing voluntary hospital and physician networks and by rewarding providers with shared savings in return for greater care coordination or other steps to improve quality and lower cost growth.

Sponsored by the Engelberg Center for Health Care Reform at Brookings and the Dartmouth Institute for Health Policy and Clinical Practice, the forum provided a thorough introduction to accountable care payment reforms and strategies. Panelists from a range of perspectives examined how ACOs can improve health care value, described how they can be adopted by both Medicare and the private sector, and highlighted key implementation challenges. In addition, Mark McClellan and Elliott Fisher introduced a plan for developing and providing technical support for ACO pilots in several areas of the country. 

Meeting Materials

• Issue Brief — Reforming Provider Payment: Moving Toward Accountability for Quality and Value »  
• Health Affairs — Fostering Accountable Health Care: Moving Forward In Medicare »
• CBO Budget Options (Dec. 2008) »