Avalere Health
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Insights

May 23, 2016

Avalere Health Podcast: ACO Prioritization

The number of ACOs has grown rapidly in the past few years reflecting the Department of Health and Human Services’ push to move 50% of Medicare spending to value-based payment models by 2018. Following payment and delivery innovation within Medicare, commercial insurers have also picked up on accountable care models. With an increased focus on value-based healthcare, ACOs will likely cover more than 100 million lives by 2020.

Listen in as Biruk talks about a new model Avalere has developed to help life sciences companies more effectively target ACOs and customize their value propositions in the diabetes space based on ACO performance. 

[Transcript]

Biruk: Hello and welcome to the latest Avalere Podcast. My name is Biruk Bekele and I serve as an Associate in the Reimbursement and Market Access Practice. Today, I would like to talk to you about a new model we’ve developed to help life sciences companies more effectively target ACOs and customize their value propositions in the diabetes space based on ACO performance.

The number of ACOs has grown rapidly in the past few years reflecting the Department of Health and Human Services’ push to move 50% of Medicare spending to value-based payment models by 2018. Following payment and delivery innovation within Medicare, commercial insurers have also picked up on accountable care models. With an increased focus on value-based healthcare, ACOs will likely cover more than 100 million lives by 2020.

Consequently, as ACOs begins to expand and gain influence in the healthcare space, life science clients need to learn how to segment these organizations and understand how to best engage with them. The ACO prioritization model developed by Avalere provides just that. The model captures a comprehensive listing of state-level, quality, and financial data that are likely to contribute to an ACO’s interest on the benefits of a product or service to treat patients with diabetes. Using the tool, the client will be able to modify assumptions on these important factors, generate a prioritized list of ACOs to target, and explore engagement opportunities in a geographic area of interest.

Finally, the tool provides a good profile of each ACO consumer allowing users to learn about important attributes of an ACO, its underlying patient population and its performance on outcomes-based quality measures that affect its ability to earn greater incentive payments. Access to this critical information could help field teams and account managers be more consumer-centric and tailor their value messages to specific organizations.

Moving forward, updated versions of the model will build on more powerful insights as there is a greater focus on quality reporting. Additionally, there are opportunities to expand analysis of the tool to other disease states such as heart failure or depression. Tools such as this will be critical in helping manufacturers to understand customer needs, identify gaps in quality of care, develop targeted value messages, and create patient and physician resources with a consistent narrative.

One resource that has been instrumental in helping to build the model and assess ACOs is the Avalere ACO Tracker. Since 2012, Avalere has tracked public and private ACOs spanning Medicare, Medicaid, and commercial programs. The ACO Tracker contains the most up-to-date listing of ACOs and key information such as service area, start date, and level of financial risk. In addition, the Tracker has quality and financial performance data (2013 & 2014) for ACOs in the Medicare Shared Savings Program (MSSP).  

For more information, please feel free to contact me, Biruk Bekele, at bbekele@avalere.com. Thank you. 

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