Is Australia ready for Accountable Care? - academic, policy and service provider perspectives

Abstract

Background : Healthcare organisations are increasingly adapting their delivery system models to focus on total populations and move away from volume-driven, fee-for-service models. One key example of this change internationally is with the establishment of Accountable Care Organizations (ACOs) where provider groups are held accountable for the total costs and quality of care for a defined population. In this workshop we will offer an academic, policy and service provider perspective on the applicability of ACO models of care for Australia. Aims and objectives : The objective of the workshop is to critically appraise international ACO models and to understand the cultural, policy and implementation considerations that need to be considered if such models are to be considered in Australia. Format : The workshop will be delivered in four parts. Part 1: The findings from an evidence synthesis of accountable care models will be presented. We will highlight what is known about the structures, capabilities and outcomes of these models and highlight exemplar models that are most relevant to the Australian health system. Part 2: The Australian and NSW policy environment will be reviewed. Several initiatives at both federal and state levels are currently underway with the aim of moving the health system toward population-based care delivery models. These will be reviewed and their relevance to ACOs will be discussed. Part 3: The implementation considerations of population-based health care delivery models will be discussed from a service provider perspective. The North Coast Primary Health Network and the the Northern New South Wales Local Health District are implementing several projects exploring locally driven strategies to address care fragmentation. Examples include projects to enhance consumer health literacy and self-management, support for patients at high risk of hospitalisation during winter and the 'reverse ambulance' program. Such strategies feature strong consumer and community engagement using co-design principles, pooled funding and commissioning of services, and establishing critical infrastructure to enhance sustainability. Part 4: In the final part we will engage workshop participants to: (1) critically appraise the information presented; (2) identify the models and model components of ACOs that are most relevant to Australia; (3) understand what policy reforms are needed to enable these models; and (4) identify potential risks and unintended consequences of their implementation. Target audience : We encourage a diverse audience of consumers, service providers (from primary through to tertiary care), managers, and funders to bring their unique perspectives to this workshop. Learnings : Health systems around the world are exploring innovative funding and care delivery models to improve health and performance outcomes. This workshop will make an important contribution to the dialogue on health system reform in Australia.