Tags

Type your tag names separated by a space and hit enter

Growth of Accountable Care Organizations in California: Number, Characteristics, and State Regulation.
J Health Polit Policy Law. 2015 Aug; 40(4):669-88.JH

Abstract

Accountable care organizations (ACOs) result in physician organizations' and hospitals' receiving risk-based payments tied to costs, health care quality, and patient outcomes. This article (1) describes California ACOs within Medicare, the commercial market, and Medi-Cal and the safety net; (2) discusses how ACOs are regulated by the California Department of Managed Health Care and the California Department of Insurance; and (3) analyzes the increase of ACOs in California using data from Cattaneo and Stroud. While ACOs in California are well established within Medicare and the commercial market, they are still emerging within Medi-Cal and the safety net. Notwithstanding, the state has not enacted a law or issued a regulation specific to ACOs; they are regulated under existing statutes and regulations. From August 2012 to February 2014, the number of lives covered by ACOs increased from 514,100 to 915,285, representing 2.4 percent of California's population, including 10.6 percent of California's Medicare fee-for-service beneficiaries and 2.3 percent of California's commercially insured lives. By emphasizing health care quality and patient outcomes, ACOs have the potential to build and improve on California's delegated model. If recent trends continue, ACOs will have a greater influence on health care delivery and financial risk sharing in California.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Fulton BD
University of California, Berkeley.
Pegany V
University of California, Berkeley.
Keolanui B
University of California, Berkeley.
Scheffler RM
University of California, Berkeley.

MeSH

Accountable Care OrganizationsCaliforniaCenters for Medicare and Medicaid Services, U.S.Delivery of Health Care, IntegratedGovernment RegulationHumansManaged Care ProgramsMedicaidMedicareQuality of Health CareRisk Sharing, FinancialState GovernmentUnited States

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26124303

Citation

Fulton, Brent D., et al. "Growth of Accountable Care Organizations in California: Number, Characteristics, and State Regulation." Journal of Health Politics, Policy and Law, vol. 40, no. 4, 2015, pp. 669-88.
Fulton BD, Pegany V, Keolanui B, et al. Growth of Accountable Care Organizations in California: Number, Characteristics, and State Regulation. J Health Polit Policy Law. 2015;40(4):669-88.
Fulton, B. D., Pegany, V., Keolanui, B., & Scheffler, R. M. (2015). Growth of Accountable Care Organizations in California: Number, Characteristics, and State Regulation. Journal of Health Politics, Policy and Law, 40(4), 669-88. https://doi.org/10.1215/03616878-3149988
Fulton BD, et al. Growth of Accountable Care Organizations in California: Number, Characteristics, and State Regulation. J Health Polit Policy Law. 2015;40(4):669-88. PubMed PMID: 26124303.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Growth of Accountable Care Organizations in California: Number, Characteristics, and State Regulation. AU - Fulton,Brent D, AU - Pegany,Vishaal, AU - Keolanui,Beth, AU - Scheffler,Richard M, Y1 - 2015/06/29/ PY - 2015/7/1/entrez PY - 2015/7/1/pubmed PY - 2016/9/1/medline KW - California KW - accountable care organizations KW - health insurance regulation SP - 669 EP - 88 JF - Journal of health politics, policy and law JO - J Health Polit Policy Law VL - 40 IS - 4 N2 - Accountable care organizations (ACOs) result in physician organizations' and hospitals' receiving risk-based payments tied to costs, health care quality, and patient outcomes. This article (1) describes California ACOs within Medicare, the commercial market, and Medi-Cal and the safety net; (2) discusses how ACOs are regulated by the California Department of Managed Health Care and the California Department of Insurance; and (3) analyzes the increase of ACOs in California using data from Cattaneo and Stroud. While ACOs in California are well established within Medicare and the commercial market, they are still emerging within Medi-Cal and the safety net. Notwithstanding, the state has not enacted a law or issued a regulation specific to ACOs; they are regulated under existing statutes and regulations. From August 2012 to February 2014, the number of lives covered by ACOs increased from 514,100 to 915,285, representing 2.4 percent of California's population, including 10.6 percent of California's Medicare fee-for-service beneficiaries and 2.3 percent of California's commercially insured lives. By emphasizing health care quality and patient outcomes, ACOs have the potential to build and improve on California's delegated model. If recent trends continue, ACOs will have a greater influence on health care delivery and financial risk sharing in California. SN - 1527-1927 UR - https://www.unboundmedicine.com/medline/citation/26124303/Growth_of_Accountable_Care_Organizations_in_California:_Number_Characteristics_and_State_Regulation_ DB - PRIME DP - Unbound Medicine ER -