Better to Best: Elements to Achieve Accountable Care

Introduction

Medical home and accountable care models incorporate the best evidence and the best ideas to drive value in the health care system. But the forward momentum propelling these models cannot be explained by new ideas or new evidence alone. What is historic is the magnitude of the collaboration, the broad inclusion of a wide variety of stakeholders, and the diverse and dedicated leadership that spans the private and public sectors and hails from every corner of the health care sector. This report presents action items for moving forward to a value-based health care system.

The product of multi-disciplinary discussion and lively debate, the report delves beyond the boundaries of specific delivery system models and addresses fundamental themes essential to improving care and stemming rising costs. It presents recommendations for immediate action by stakeholders ranging from policymakers to providers and researchers. The themes, or “value-driving elements,” that are the focus of this report are access, care coordination, health information technology and payment reform. The first two are elements of health care delivery that require urgent overhaul to maximize health outcomes at lower costs. The latter two are essential tools, without which widespread implementation of new care delivery models will not succeed. These are not the only elements of our current health care system that require attention, but progress in each of these areas is necessary to optimize value in health care. Every U.S. community can benefit from expanded access and improved care coordination spurred by health information technology and payment reforms. The question is where and how to begin.