• Ease of entry into value-based reimbursement – Value-based reimbursement is here whether a provider joins a clinically integrated network or not. Medicare has created a roadmap for clinically integrated networks which eases the way into the value-based system without violating anti-trust laws.
  • Patient retention and loyalty – Patient retention is key to any provider’s success. When patients receive well-managed care and experience better outcomes, they are far more likely to stay loyal to their provider. With consumerism in healthcare on the rise, patients will be seeking the high quality, better value providers to receive their care from.
  • The driving force behind government backed ACOs, the Centers for Medicare and Medicaid Services (CMS), has made it clear that it plans to support the ACO movement for years to come. New and evolving ACO models suggest that, certainly for the next ten years or more, ACOs and clinically integrated networks will be a dominant form of payment for the medical community. CMS has paid attention to criticism, it has asked for feedback, and it is now forging ahead and working to improve upon early ACO plans. By doing this, CMS is demonstrating that it is committed to pushing forward and being more innovative and fairer with accountable care.
  • Commercial payers are following Medicare’s lead.
  • As we have seen happen with many other initiatives, the private sector is following Medicare’s example and moving rapidly in the direction of leveraging clinically integrated networks to increase value and quality. Aetna, Blue Cross, Cigna, Humana, UnitedHealthcare and other large commercial payers have created models that provide care to millions of Americans. Like CMS-supported ACOs, participation in commercial payer ACOs is expected to continue to grow.