Orchestrating ACO success: how top performers achieve shared savings.

Leaders of the top-performing accountable care organizations in the Medicare Shared Savings Program attribute the success of their organizations in large part to seven strategies: Seek action-oriented leadership. Transform primary care physician practices. Keep patients out of the emergency department.

Developing a CIN for strategic value.

Clinically integrated networks (CINs) allow health systems and independent physicians to join in a mutually beneficial effort to adapt to new payment models. Key issues during planning for a CIN include organizational structure and governance, payer contracts, and incentive funds distribution. In assessing the network's potential financial impact, CIN planners should think in terms of managing total cost of care rather than in terms of revenues for care delivered.

Medicare bundled payment: what is it worth to you?

Hospital leaders who are contemplating participation in a bundled payment initiative should first assess current circumstances to determine the extent of the opportunity for their organizations. Those who have decided conditions are favorable for such an initiative should next perform a financial assessment that includes modeling direct contract results, assessing the financial impact of reduced utilization and of improved clinical care and operations, and evaluating the net financial impact. Hospital executives also should understand the competitive and strategic benefits that bundled payment offers.

Value-based physician compensation tackling the complexities.

Hospital and health system leaders should address six important questions before shifting to a quality-focused physician compensation plan: Does the shift to a value-based compensation model present opportunities beyond the addition of quality incentives? Should measures be universal or aligned with specific payer initiatives? How much of an incentive is enough? How should quality and cost-effectiveness be measured? How should performance on the measures be assessed? How will total and individual compensation be affected?