At the annual Becker's Hospital Review CEO Strategy Roundtable Nov. 14 in Chicago, Brian Silverstein, MD, president of HC Wisdom, discussed hospital-based accountable care organizations for employees.
According to Dr. Silverstein, hospital employee ACOs are "plentiful" and spread across the county. He named Columbia, Md.-based MedStar Health and Summa Health System in Akron, Ohio, as two examples of health systems with an ACO for their employees. Duke also offers DukeWell, a care management program, to its employees, he said.
These programs allow hospitals to control their employees' healthcare spend, and that can have a huge impact on their bottom line. "If revenue is flat and [employee] healthcare costs is up 3 percent, you lose," Dr. Silverstein said. As profits become harder to attain for many healthcare organizations, keeping healthcare costs of their employees down is a key for success.
Controlling employee healthcare spend is not the only opportunity employee ACOs hold for hospitals, however. Programs like employee ACOs show commercial payers in the area that the hospital is capable of managing the health of one population — which can pave an easier path to commercial ACO contracts, according to Dr. Silverstein.
Challenges follow opportunities, though, and there are several challenges facing hospitals that want to form an ACO for their employee base. However, these challenges also are present in commercial payer and Medicare ACOs. For instance, ACOs in general drive down volume, theoretically driving down revenue. So, hospitals have to make sure they are capturing any savings achieved from the ACO efforts.
Another challenge associated with employee ACOs include being able to capture and use the right data. "A big limiter is having the right information," Dr. Silverstein said.
If hospitals are willing to face the challenges associated with forming an ACO for their employee base, they can reap the benefits of saving money on employee healthcare and can also use it as a population health proving ground of sorts and leverage it into commercial ACO contracts with payers in the area.