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Humana, Norton Healthcare launch latest payer-provider ACO

Two Kentucky-based companies, Humana and Norton Healthcare, are launching the region's first commercial Accountable Care Organization.

The Norton-Humana partnership began earlier this year and is one of five sites in a pilot program sponsored by The Engelberg Center for Health Care Reform at the Brookings Institution and The Dartmouth Institute for Health Policy and Clinical Practice.

"Norton Healthcare's work in developing an integrated healthcare delivery system and Humana's commitment to continuous improvement in quality provide a strong foundation from which to pilot the payment reforms central to ACOs," said Elliott Fisher, MD, director of the Center for Population Health at The Dartmouth Institute for Health Policy and Clinical Practice.

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The ACO model is being tested under a number of different payer-provider collaborations around the country. Expectations are that the ACO model will become more widespread under health reform as one that creates financial incentives for healthcare providers to become accountable for the efficiency and effectiveness of the care they provide. The model is in direct contrast to the current fee-for-service model, which rewards care volume over results.

"Considering our healthcare system's industry-leading commitment to measuring and openly reporting on the quality of our care, our progress toward a system-wide integrated electronic medical record and our large base of employed primary and specialty-care physicians, Norton Healthcare was the logical choice in our region to be an ACO pilot participant," said Steve Hester, MD, Norton's senior vice president and chief medical officer.

The Brookings-Dartmouth team – considered one of the leaders in promoting the ACO model – is led by Fisher and Mark McClellan, MD, director of the Engelberg Center for Health Care Reform at the Brookings Institution. They are working with Humana and Norton Healthcare to offer technical and strategic support in the implementation of the ACO model.

Humana has worked with Brookings-Dartmouth since 2008 on exploring the ACO concept and other innovative payment models, said Bruce Perkins, senior vice president of Humana's healthcare delivery systems and clinical processes organization.

"Humana is committed to innovative local and national models that improve clinical outcomes, reduce costs and improve efficiencies," he said. "Humana plans to continue to develop more ACO models by partnering with providers in multiple regions. Our focus in exploring additional ACO relationships is to help drive innovation in the marketplace."

In addition to the project in Kentucky, the Brookings-Dartmouth ACO Pilot Project includes pilot sites at the Carilion Clinic in Roanoke, Va.; Tucson Medical Center in Tucson, Ariz.; HealthCare Partners Medical Group in Torrance, Calif.; and Monarch HealthCare in Irvine, Calif.