Suburban Health Organization’s (SHO’s) partnering hospitals have had varying levels of collaboration in population health contracts since our first foray into the world of traditional Medicare Shared Savings Program ACOs in 2015. Although a number of our partner hospitals have had relationships with other ACO entities, generally speaking, we have had an increasing degree of collaboration through Medicare Advantage contracts with Anthem and United Health (now facilitated by Optum Health). Historically, these contracts have all been upside only, meaning that we could share in potential savings without the risk of financial loss if we failed to achieve savings in the cost of care for the population. A common theme for every population health contract is that we are on the precipice of being required to accept progressive downside financial risk. The acceptance of risk therefore requires a heightened level of mutual accountability between partnering organizations.
Over the past year, all twelve SHO hospitals have met though an “ACO Vision Taskforce” to define this mutual accountability and review the optimal approach to facilitate success under risk-based population health contracts. The culmination of this group’s work has been
- The identification of mutual accountability standards.
- An agreement from each partnering organization to develop a revised provider compensation model that is aligned with population health goals. Such models will be developed during the course of 2022 for implementation in 2023.
- The creation of the Population Health Board.
The Population Health Board has representation from each of the twelve SHO Class B and Affiliate organizations, typically from the CEO and Director of Population Health. The Board’s annual workplan will be informed by activities at the Population Health Council level, attended by Quality Directors and Care Coordinator leads. The workplan activities will be implemented through the work of the Physician Practice Council, Primary Care Council, Population Health Council, and other relevant groups. Elevating population health oversight to a “Board” is expected to facilitate the highest levels of inter-hospital accountability and ensure nimble decision making to promote success.
Additionally, those organizations that are continuing a partnership with Caravan Health in 2022 now reside within large collaborative ACOs. Because Caravan ACO governance will involve multiple organizations beyond Suburban Health Organization, the Population Health Board will also serve as an opportunity for Caravan Health ACO members (and non-Caravan Health MSSP participants) to discuss local issues pertaining to MSSP performance.