Rapid evidence profiles on accountability models within local-health systems

RISE recently produced two rapid-evidence profiles related to accountability. The rapid-evidence profiles examine the following questions:

• What do we know from the best-available evidence and from the experience of other jurisdictions about accountability models that are focused on primary-care organizations and providers participating in local-health system initiatives?
• What do we know from the best-available evidence and from the experiences of other jurisdictions about the functions that local-health systems or networks of care are responsible for and the ways in which they are held accountable for performing these functions?

In both instances, the profiles found that literature related to the implementation of accountability models within local-health systems is still developing. For accountability models focused on primary-care providers and primary-care organizations, formal mechanisms were most frequently used, often employing contracts which tie performance expectations to economic incentives.

For accountability within local-health systems or networks of care, the reviews included in the evidence profile found that the most frequent mechanisms to ensure accountability included economic instruments and education and information instruments.

Experiences from Canadian and international initiatives were also included, such as from primary care networks in each of British Columbia and Alberta, Integrated Health and Social Service Centres in Quebec, U.S. accountable care organizations, U.K. integrated care systems (and previous experience with clinical commissioning groups), and Australian Primary Health Networks, to name a few.