Giving Compass' Take:

• Ryan Marling reports that high turnover in treatment for patients with chronic health problems presents a problem when it comes to accountability. 

• How can these systems be interlinked to better track patient care? How does this issue fit into the larger conversation about U.S. healthcare policy? 

• Learn about Health Leads, a social enterprise that envisions a healthcare system that addresses all patients' basic resource needs as a standard part of quality care.

The nature of the healthcare problem facing America is increasingly defined by chronic conditions. In 2014, 60% of Americans had at least one chronic condition, and 42% had multiple chronic conditions. Treating those suffering from chronic disease accounts for a whopping 90% of total healthcare spending in the U.S.

Chronic conditions are not cured, but managed over a long period of time, often lasting the remainder of a person’s life after diagnosis. Effective treatment simply aims to prevent additional adverse reactions associated with the condition over time. However, potential savings from such long-term treatment plans typically don’t materialize until years down the road.

Given this long time horizon, one limitation of these new models is the rate at which patients churn in and out of the programs.

The average amount of time patients are actually part of newly formed ACO models is short, with annual churn rates among patients estimated at around one in four. This means that after three years, there’s less than a one in two likelihood that a patient is still enrolled in the ACO model.

This presents a problem, as financial accountability for patient health lasts only as long as the patient is expected to be within the accountable care model.

Read the full article on accountable care by Ryan Marling at Christensen Institute.