Todd A. Zigrang, MBA, MHA, FACHE, CVA, ASA, ABV, president of Health Capital Consultants, discusses accountable care organizations (ACOs) and the move toward value-based care models.
Todd A. Zigrang, MBA, MHA, FACHE, CVA, ASA, ABV, president of Health Capital Consultants, discusses accountable care organizations (ACOs) and the move toward value-based care models.
Transcript
How do ACOs fit into the overall shift to value-based care?
Value-based care encompasses a broad variety of payment options and models in which health care providers are incentivized to provide better care at lower costs. So ACOs are just one of many different models that fit into value-based care.
We have the providers such as physician groups, hospitals, other outpatient facilities—they take responsibility for the costs, quality, and most importantly, care coordination of its patients. ACOs were created, in a way, to push the industry away from fee-for-service medicine towards value-based care. So I think when we think about ACOs, that's probably the first stepping stone we saw with the Affordable Care Act towards value-based care.
Technically, when I think of value-based care and value, it's quality over cost, that equation. So everything I do in valuation—which is why I'm speaking at the conference: to talk about the valuation in the appraisal of ACOs—I think of some kind of mathematical equation. So ACOs, models, they don't have a universal definition of value, which kind of makes it challenging for ACOs, to continue generating success, if the target by which they're measured constantly moves from year to year.
But those of us in the industry, we kind of recognize that ACOs are a step along a path towards value-based care. I don't think that they'll be the end-all destination. That destination is years and years away, as we've seen how long it's taken to get to this point. I've been in health care for almost 30 years now, and I recall the Clinton administration moving into health care reform. And here we are, still talking about, they're still trying to get there.
The Push for Fair Pricing and Reform in Pharmacy Benefit Management
April 3rd 2025Amid growing legislative pressures and industry debates, pharmacy benefit managers (PBMs) are exploring new strategies to enhance transparency, reduce patient costs, and navigate the evolving healthcare landscape.
Read More
Using AI-Driven Strategies to Optimize Specialty Drug Costs, Manage Polypharmacy
April 2nd 2025As health care costs continue to rise, artificial intelligence (AI)-driven solutions are emerging as a powerful tool for managing specialty drug spending and polypharmacy risks, as showcased in recent research presented at the Academy of Managed Care Pharmacy 2025 conference.
Read More
Areas of Unmet Need Continue to Burden Patients With gMG
April 2nd 2025Patient-reported outcomes measures in generalized myasthenia gravis (gMG) are more important than ever, for both those treating and being treated for the chronic autoimmune neuromuscular disorder, to have a more nuanced understanding of experiences and difficulties.
Read More