I don’t think anyone has figured this out for sure.
My two pieces of advice are that any metrics tied to data need to be VERY clear and understood by both sides. I also think the more frequently the metric is fed to the physicians the more effective they are. Reporting quarterly is probably not enough.
May the quality/service components meaningful. I think many models don’t have set at a high enough percentage to be meaningful. I think at least 10% is needed.
On point #2.
We have tried keeping feet in both worlds but have found that to be very difficult and sends all kinds of mixed messages to providers and departments. Currently using ACO to try to push the entire organization to VBC since it will cover so many patients.
On point #3.
We had a previous partnership with a clinic that was joining an ACO run by an outside company that specializes in setting up ACOs comprised of multiple systems to scale to about 100,000 covered patients. The outside company also takes some of the risk.
I’m wondering if there would be a role for outpatient therapies like physical or occupational therapy. Seems there is a lot of space and these require decent amounts of space.
It seems staying with in known areas would be safer.
Our dyads have very intentionally sat down and mapped out who has responsibility for what. At our executive leadership team they also occasionally start a meeting reminding each other to “stay in their lanes”.