Accountable care around the world: a framework to guide reform strategies.

Journal Article (Journal Article)

Accountable care--a way to align health care payments with patient-focused reform goals--is currently being pursued in the United States, but its principles are also being applied in many other countries. In this article we review experiences with such reforms to offer a globally applicable definition of an accountable care system and propose a conceptual framework for characterizing and assessing accountable care reforms. The framework consists of five components: population, outcomes, metrics and learning, payments and incentives, and coordinated delivery. We describe how the framework applies to accountable care reforms that are already being implemented in Spain and Singapore. We also describe how it can be used to map progress through increasingly sophisticated levels of reforms. We recommend that policy makers pursuing accountable care reforms emphasize the following steps: highlight population health and wellness instead of just treating illness; pay for outcomes instead of activities; create a more favorable environment for collaboration and coordinated care; and promote interoperable data systems.

Full Text

Duke Authors

Cited Authors

  • McClellan, M; Kent, J; Beales, SJ; Cohen, SIA; Macdonnell, M; Thoumi, A; Abdulmalik, M; Darzi, A

Published Date

  • September 2014

Published In

Volume / Issue

  • 33 / 9

Start / End Page

  • 1507 - 1515

PubMed ID

  • 25201654

Electronic International Standard Serial Number (EISSN)

  • 1544-5208

International Standard Serial Number (ISSN)

  • 0278-2715

Digital Object Identifier (DOI)

  • 10.1377/hlthaff.2014.0373


  • eng