Workshop 1: April 24 and 25, 2014
A special issue of the Journal of Health Politics, Policy and Law was commissioned from papers created for the 2014 ACO workshop. The “Assessing Accountable Care Organizations: Cost, Quality, and Market Power” a special issue (volume 40, issue 4), is an in-depth look at accountable care organizations (ACOs): networks of hospitals, physicians, or other health care providers that share financial and medical responsibility for the coordinated care of a patient. The articles below are works supported by the Petris Center.
The press release announcing the journal’s publishing can be found here, and the full journal can be accessed here.
Introduction
- Accountable Care Organizations: Integrated Care Meets Market Power – Richard M. Scheffler
Part I: The Current Landscape
- Accountable Care Organizations: The National Landscape – Stephen M. Shortell, Carrie H. Colla, Valerie A. Lewis, Elliott Fisher, Eric Kessell, and Patricia Ramsay
- Growth of Accountable Care Organizations in California: Number, Characteristics, and State Regulation – Brent D. Fulton, Vishaal Pegany, Beth Keolanui, and Richard M. Scheffler
- Accountable Care Organizations in California: Market Forces at Work? – Christopher Whaley, H. E. Frech III, and Richard M. Scheffler
- Commentary – Accountable Care Organizations and Narrow Network Insurance Plans – Ben Handel
Part II: What Do We Wants ACOs to Achieve and Can They Do It?
- Addressing Pricing Power in Integrated Delivery: The Limits of Antitrust – Robert Bernenson
- The Economics of Provider Payment Reform: Are Accountable Care Organizations the Answer? – Roger Feldman
- Review of Medicare, Medicaid, and Commercial Quality of Care Measure: Considerations for Assessing Accountable Care Organizations – Eric Kessell, Vishaal Pegany, Beth Keolanui, Brent D. Fulton, Richard M. Scheffler, and Stephen M. Shortell
- Integration of Substance Abuse Treatment Organizations into Accountable Care Organizations: Results From a National Survey – Thomas D’Aunno, Peter D. Friedmann, Qixuan Chen, and Donna M. Wilson
- Accountable Care Organizations and Population Health Organizations – Lawrence P. Casalino, Natalie Erb, Maulik S. Joshi, and Stephen M. Shortell
Part III: ACO Accountability and Enforcement: An Overview and Perspective Essays
- Antitrust and Provider Collaborations: Where We’ve Been and What Should Be Done Now – Robert F. Leibenluft
- Accountable Care Organizations and Antitrust Enforcement: Promoting Competition and Innovation – Deborah L. Feinstien, Patrick Kuhlmann, and Peter J. Mucchetti
- A Few Thoughts about ACO Antitrust Issues From a Local Enforcement Perspective – Kathleen E. Foote and Emilio E. Varanini
Workshop 2: May 8, 2015
Panel 1: State Experiences and Existing Approaches for Regulating ACOs
In this panel, speakers and commentators summarized existing approaches for regulating ACOs among those states that have the most experience and innovation in this area. These regulations might address anti-competitive behavior, quality of care, network adequacy, and reporting requirements. We also asked speakers to consider the various successes and failures of alternative regulatory approaches.
Chair
- Kathleen Foote, JD; Senior Assistant Attorney General and Antitrust Chief, Attorney General’s Office, State of California
Participants
- Kim Van Winkle, JD, MPA; Antitrust Section Chief, Texas Attorney General’s Office
- Katherine Mills, JD, MPH; Acting Policy Director for Market Performance Massachusetts Health Policy Commission
- Herb Olson, JD; Legal Counsel, Rhode Island Office of the Health Insurance Commissioner
- James R. Knickman, PhD; President and Chief Executive Officer of the New York State Health Foundation
- Ann Hollingshead, MPP (Candidate); Research Associate, Nicholas C. Petris Center, School of Public Health, University of California, Berkeley
Commentator
- Greg Burke, MPA; Director of Innovation Strategies; United Hospital Fund of New York City (UHF)
Panel 2: Exploring Regulatory Options to Ensure a Competitive Market
In this panel, speakers and commentators explored potential and future approaches for regulating anti-competitive practices, including mergers and exclusivity contracts, and alternatives for regulators to reduce the potential for anti-competitive behavior.
Moderator
- Emilio Varanini, JD; Deputy Attorney General in the Antitrust Section, State of California
Participants
- Thomas N. Dahdouh, JD; Regional Director of the Federal Trade Commission’s Western Region offices in San Francisco and Los Angeles, Federal Trade Commission
- Joshua Soven, JD; Partner, Gibson, Dunn & Crutcher LLP, Washington, D.C. Office
- Ann M. Marciarille, PhD; Associate Professor School of Law, University of Missouri
- Jaime S. King JD, PhD; Professor of Law, University of California, Hastings College of Law; Associate Director of the University of California, San Francisco/University of California, Hastings Consortium on Law, Science and Health Policy; Executive Editor of The Source on Healthcare Price and Competition
Commentators
- Maribeth Shannon, MSHA; Director, Market and Policy Monitor Program, California Healthcare Foundation
- Emilio Varanini, JD; Deputy Attorney General in the Antitrust Section, State of California
Panel 3: Financial and Clinical Integration of ACOs
In this panel, speakers and commentators will explore different types of integration and consider their implications for patient quality, costs, and regulations. Some potential topics include: (1) a taxonomy of ACOs that describes the existing array of integrated structures; (2) payer-provider and provider-provider legal relationships that achieve optimize quality improvements without corresponding increases in costs; and (3) a discussion of the tradeoffs and benefits of financial integration over clinical integration.
Moderator
- Stephen Shortell, PhD, MBA, MPH; Blue Cross of California Distinguished Professor of Health Policy and Management; Director, Center for Healthcare Organizational and Innovation Research (CHOIR); Dean Emeritus, School of Public Health; Professor of Organization Behavior, Haas School of Business, University of California, Berkeley
Participants
- Gerald F Kominski, PhD; Professor, Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles; Director, University of California, Los Angeles Center for Health Policy Research
- Jill Yegian, PhD; Interim-Chief Executive Officer and Senior Vice President for Programs, Integrated Healthcare Association
- Bruce Bodaken, MS; Visiting Scholar; Brookings Lecturer, School of Public Health, UC Berkeley; Former Chairman, President and CEO, Blue Shield of California
- John Wiegand, JD; Attorney, Federal Trade Commission – San Francisco Office
- Kenneth W. Kizer, MD, MPH, Distinguished Professor and Director, Institute for Population Health Improvement, University of California Davis
Commentators
- Stephen Shortell, PhD, MBA, MPH; Blue Cross of California Distinguished Professor of Health Policy and Management; Director, Center for Healthcare Organizational and Innovation Research (CHOIR); Dean Emeritus, School of Public Health; Professor of Organization Behavior, Haas School of Business, University of California, Berkeley
- Laurence Baker, PhD; Health Economist and Professor of Health Research and Policy at Stanford University