Health plans embracing ACOs, boosting IT, study shows

Ellen Donahue-Dalton

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.