Lost (and Found) in Translation: Applying the Accountable Care Framework to Support the Diffusion of Health Innovations

Abstract

Rising health expenditures and growing disease burden have generated new impetus for value-based health reforms across the world. However, fragmented evidence for implementation science in health policy limits the design and diffusion of health innovations to fill common gaps in care delivery. This paper explores how the accountable care framework can be used as a model for adapting international health innovations to improve outcomes and reduce costs for high-need, high-cost populations in the United States. A national advisory board of health policy experts and leaders was convened to identify the primary challenges faced by systems today. These criteria were used to develop a standardized survey for reviewing the global landscape of health innovations that increase access, improve outcomes, and reduce cost, resulting in a curated database of 175 international delivery and payment innovations. Innovations were analyzed using the accountable care framework for trends in performance, methodology, and diffusion experience. These insights were then synthesized into a model for translating innovations across health systems. To validate the model, three partner institutions – CareSouth Carolina, the University of Arkansas for Medical Sciences, and the Henry Ford Health System – were selected as use cases in the United States. Value-based readiness assessments were administered to the senior leadership teams of each health system, who then participated in an iterative six-month process to co-design an integrated solution set using the adaptation model, with feedback from health systems confirming the model’s applicability to support the diffusion of innovations to the health policy context of the United States. The results of this work offer a new paradigm for health innovation and identify practical opportunities for policymakers and practitioners to support care transformation in America.