Goal is to reduce costs, improve outcomes

Ned Helms, director of the New Hampshire Institute for Health Policy and Practice at UNH

While the general public knows little about accountable care organizations, health care policy leaders and the federal government believe they may be one of the keys to transforming the medical and financial dynamics of the country's $2.6 trillion health care system.

"I get frustrated by too much talk about how the Affordable Care Act doesn't deal with health care costs," said Ned Helms, director of the New Hampshire Institute for Health Policy and Practice at the University of New Hampshire. "That's not the case. We have three programs in the state doing innovative work to deliver better care and cut costs. The goal of ACOs is to develop and replicate the best performing systems in this country not in England or France, but here."

In theory, ACOs are systems of health care providers hospitals, primary care doctors, specialists and others that assume accountability for both the costs and the quality outcomes for a defined population. They have been developing slowly over the past decade but Helms believes they are ready to take off locally and nationally.

For example, a $250,000 private foundation grant led to the launch last year of the N.H. Accountable Care Organization Pilot, a five-year project at five sites throughout the state: Exeter Health Resources, Central New Hampshire Health Partnership in Plymouth, Southern New Hampshire Health System in Nashua, Cheshire Medical Center/Dartmouth Hitchcock Medical Center Keene, and a North Country consortium of Cottage Hospital, Littleton Hospital and Ammonoosuc Community Health Services.

Helms said the pilot program is focused on a multifaceted approach of changing the way health care is delivered and paid for by moving away from the traditional "fee-for-service," which contributes to the most expensive health care system in the world and with quality and quantity outcomes that do not match the money spent.

"Our system for financing and delivering health care is seriously flawed," Helms said. "It is tremendously important and encouraging that these five systems have decided to work together to make a concerted collaborative effort to reform and improve the system."

Wentworth-Douglass Hospital in Dover belongs to another ACO development organization, the Granite Healthcare Network, which also includes Concord Hospital, Elliot Hospital in Manchester, LRGHealthcare in Laconia and Southern New Hampshire Medical Center in Nashua.

Helms says collaboration and cooperation are the keys to maximizing the strengths of each hospital, clinic and health care provider as they share costs, treatments and a focus on overall healthier outcomes.

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Providers group as Accountable Care Organizations