The most common risk-bearing arrangements among surveyed health systems

Medicare Advantage is the most popular risk-bearing arrangement among  health systems, according to a new survey.

The survey of healthcare system executives found that 93 percent of systems are participating in Medicare Advantage.

Respondents also identified provider-owned health plans (73 percent), commercial payer contracts (60 percent), and bundled payment for care improvement models (60 percent) as common. 

Arrangements that were less popular included Managed Medicaid (40 percent), Medicare Shared Savings Plan accountable care organizations (40 percent), and Next Generation ACOs (33 percent).

Researchers said they found no apparent association between organization size and participation in arrangements. However, they did find that large health systems (total operating revenue of more than $5 billion) participate in an average of five  programs. Small (total operating revenue of less than $2 billion) and medium (total operating revenue of $2 billion to $5 billion) systems participate in four programs, on average.

“In 2019, most health systems are focused on increasing the number of covered lives within their existing risk programs, as opposed to joining new programs,” the researchers wrote. “Health systems most commonly expect the highest growth of covered lives in their commercial payer contracts over the next year, but this is primarily subject to local market dynamics specific to each health system. Others expect the most growth among their MA, ACO or Managed Medicaid populations.”

The survey was conducted in February by the Health Management Academy for Lumeris, a value-based care management provider.

Respondents represent organizations that own or operate 168 hospitals with 38,055 beds.

 

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