One major challenge in the U.S. has been that healthcare funding and incentives have not included resources to address the social causes of health inequities. This has perpetuated the problem. Conversely, several European countries have combined funding for health and social services and created incentives for communities and organizations to address both areas collectively.
Over the past 10 years, accountable care organizations (ACOs) have focused on implementing value-based care and new value-based payment models. The impact of this effort is well documented. According to CMS, the ACO model has increased Medicare savings for seven straight years, culminating in a $4.1 billion in savings in 2020. A key question is a portion of these savings the result of the model itself, or the product of selective enrollment or exclusion of patient populations most challenging to manage?