what new care models may mean for accountability and commissioning rachael addicott, senior research...
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![Page 1: What new care models may mean for accountability and commissioning Rachael Addicott, Senior Research Fellow r.addicott@kingsfund.org.uk @RachaelAddicott](https://reader035.vdocument.in/reader035/viewer/2022062805/5697c00b1a28abf838cc83c9/html5/thumbnails/1.jpg)
What new care models may mean for accountability and commissioning
Rachael Addicott, Senior Research Fellow [email protected] @RachaelAddicott
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Looking for new ideas
Accountable Care OrganisationAlliance Contract Prime Contract
All focus on integrated
delivery of care
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International experience› High performing integrated systems use capitated budgets for
almost all care
› Main focus is on population based budgets not disease or condition based budgets
› They specify the quality/outcomes they expect to be delivered
› Systems are not over-reliant on payment methods and financial incentives – other tools are also important
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Are we all talking about the same thing?
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Experience of organising integrated care in England
› Purchaser provider split = contractual solutions
› Population health vs disease/population segment
› Scope and boundaries
› Defining a budget
› Cost shifting and risk shifting
› New competencies
› Supply chain management
› Collective governance and accountability
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Collective accountability
› Reliance on informal influence
› Appeals to professional competitiveness
› Credibility of data
› Development and coaching – “learning opportunity”
› Financial penalties
› Removal from ACO network
soft
hard
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Four things to remember…
› Engagement with providers, patients and wider communities
› Importance of both transactional and relational approaches
› Alignment of payment mechanisms and incentives
› Focus on building governance structures and processes