California ACO's Success Linked to Cutting Variations in Care

An accountable care organization in California exhibited the model's potential success, due in part to its sharp focus on reducing variations in care, according to a San Francisco Chronicle report.

A collaboration launched in Jan. 2010 in Sacramento involved Blue Shield, Hill Physicians and Catholic Healthcare West. The organizations coordinated care for more than 40,000 members of the California Public Employees' Retirement System, and after one year it saved $20 million.

One way the collaboration cut costs was by tackling variation. Physicians' training and personal preferences can lead them to prescribe certain treatments over others, creating differences in the number of procedures performed within and across communities.

The Sacramento groups analyzed data to determine which procedures were outliers. A thorough review revealed that certain physicians, for example, were mainly performing open hysterectomies opposed to laparoscopic hysterectomies, which are less invasive and less costly.

An investigation revealed that a number of physicians performing the open procedure were not trained in modern, less-invasive techniques. Some have since received training or have received education to differentiate candidates for open or laparoscopic hysterectomies.

Related Articles on ACOs:

Economists Wary of ACOs' Ability to Reign in Healthcare Costs
How to Achieve Accountable Care While Avoiding Downfalls of Medicare ACOs
6 New ACO Developments


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