The health care industry’s transition to accountable care will require significant cultural and operational shifts, bringing new risks that many organizations have yet to fully identify and manage.

Several initiatives associated with the transition to accountable care organizations (ACOs) may expose organizations to new reputational, legal, and compliance risks, including:

• Establishing provider networks.
• Entering into new payor contracts.
• Developing transitional care models.
• Sharing data.
• Integrating physicians and other care providers.

While many of the exposures relating to ACOs can be addressed through existing insurance solutions, organizations should ensure that their current programs will sufficiently protect them through the transition to accountable care.

For example, risk managers should determine whether existing directors and officers liability policies respond to wrongful acts related to the selection of care models and whether existing cyber/data privacy policies address exposures for affiliated providers’ access to patient data.

As they move toward accountable care, organizations must improve safety and service cultures, reevaluate risk exposures and insurance programs, and more closely align risk management with strategy. Those organizations that can meet this challenge will emerge as leaders in the next era of health care delivery.

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