National Academy of Medicine

A Path to Accountable Care

By Bruce Bodaken
April 06, 2012 | Commentary

With all the attention being paid to emerging accountable care organizations throughout the country, a California model is delivering measurable results. Catholic Healthcare West (CHW) (now Dignity Health), Hill Physicians Medical Group, and Blue Shield of California had preliminary conversations in early 2007 to find ways to work together that could lead to material improvements in the delivery system. They envisioned a delivery model that realigned incentives between the hospital, medical group, and health plan to promote cooperation and integration in a financially viable way for all parties. This model also incorporated aggressive cost-saving initiatives to reduce waste and duplication, not just shift cost within the system.

The parties would accomplish this vision through:

  • In-depth population assessment: Identify cost drivers and develop interventions based on clinical best practices to address those costs.
  • Data sharing: Share clinical and case-management information in order to re-move redundancies.
  • Cross-organizational collaboration: Assemble a multi-organizational and multi-disciplinary team to establish a baseline of current processes and develop new, integrated, innovative care processes tailored to the care needs of the population and to the individual patient.


Disclaimer: The views expressed in this paper are those of the authors and not necessarily of the authors’ organizations, the National Academy of Medicine (NAM), or the National Academies of Sciences, Engineering, and Medicine (the National Academies). The paper is intended to help inform and stimulate discussion. It is not a report of the NAM or the National Academies. Copyright by the National Academy of Sciences. All rights reserved.