Blog: If you've seen one ACO incentive program …

Diversity is a big issue in healthcare and not just with patients, caregivers and executives. It turns out there's diversity in financial incentives that are part of the accountable care organization phenomenon.

In Maryland, doctors will be paid bonuses later this year tied to quality reporting under a new shared-savings payment model. The experiment includes the state's five largest insurers and Medicaid managed care.

In Minnesota, early results of bundled payments for heart attacks did not yield savings, but similar payments for diabetes, hypertension, coronary artery disease and hip and knee replacements appear on track to share savings with providers in Illinois and Pennsylvania who have had success reducing potentially avoidable complications.

And in Massachusetts, the state's second-largest health plan agreed to share half of any savings earned against an agreed-upon budget target. The insurer keeps the first 2% and caps payouts at 6% of the target.

These efforts at payment reform and others are part of six case studies in a newly released report supported by the Commonwealth Fund. The report, authored by consultants and a science journalist, includes a few tantalizing details about new payment arrangements being developed and tested by insurers, hospitals and physicians.

The half-dozen profiles underscore the diversity of payment reform efforts under way as the industry seeks to jettison fee-for-service. But authors did find some common ground—including “a belief that shared-savings programs must evolve to include shared risk, and a conviction that even when pilot programs fail to achieve savings, they are moving in the right direction.”

What incentives do you think will work best with ACOs? Let me know what you think at mevans@modernhealthcare.com.

You can follow Melanie Evans on Twitter: @MHmevans.