Health plans embracing ACOs, boosting IT, study shows

By Diana Manos
10:25 AM

Health plans are heading toward 100 percent participation in accountable care organizations (ACOs), according to a new study, with 78 percent of respondents already part of one, and 22 percent planning to participate in one. This is all leading to a scramble for health IT.

[See also: Health plans save big with HIEs.]

"While health plans have been preparing for a changing marketplace for a few years, the pace and clarity of their plans are ramping, and their technology needs are expanding," said Ellen Donahue-Dalton, executive vice president and chief marketing officer of Medecision, a Wayne, Penn.-based, care management solutions firm.

Medecision released an Oct. 19 report showing that many payers today are focused on bending the healthcare cost curve and improving communication with physicians.

In a Q&A with Healthcare IT News, Donahue-Dalton shared further insights:

Q: What was the most surprising thing discovered by this study?

A: We were surprised by the degree to which the priorities and investment strategies of mid-market health plans matched those of larger plans. Historically we've seen greater divergence. Mid-sized plans are looking for the same solutions as large and jumbo payers to drive consumer engagement and accountable care initiatives.

Q: What would you say is of greatest concern for health plan CIOs over the next three to five years?

A: Health plan CIOs are assessing their investment options to help their businesses survive and thrive during these turbulent times. Still in a "wait and see" mode, they are balancing cost-reduction strategies (cloud computing, updating legacy systems to leaner, more extendable options) and building capabilities for alternative care delivery models and enhanced provider and consumer connectivity.

Q: How do you think health IT investment will affect physicians participating in the plans, negatively and/or positively?

A: Healthcare stakeholders across the continuum are converging around collaborative population health management. As a consequence, new investments in healthcare IT will affect physicians very positively. Those investments will enable physicians and practices to thrive within emerging care delivery models.

[See also: ACOs digging in to stay, experts say.]

Medecision commissioned Porter Research, an Atlanta-based firm that specializes in healthcare IT research to conduct the survey. Participants were executives at U.S. health plans and represented organizations with 200,000 to 900,000 covered lives.

The plan types surveyed included commercial and managed care plans. Nearly 90 percent of the participants indicated that care management is an important component of their overall strategy.

Medecision's report is available here