Home Forums Discussions General Discussion ACOs [Accountable Care Organizations]

Just sat through a three hour panel of MDs briefing on ACOs; we heard everything from ACOs are doomed to failure to ACOs are the only hope for independent solo/small practices.

All from the same panel.

Anyhow, I am curious what folks are hearing, even though all we have are the "skeleton" in the regulations at this point.

Not to be naive but which of these represents the acronym to which you refer. :}

acute coronary occlusion
anodal closure odor
ant colony optimization
ACC oxidase
acid oxidase
acyl-CoA oxidase
alert, cooperative and oriented
anterior capsule opacification

Fair enough; Accountable Care Organizations. I'm impressed by the list by the way.

Here are some links for those so inclined:
http://www.healthreformwatch.com/20...-role-in-the-senates-health-reform-bill/
http://pnhp.org/blog/2010/07/09/what-is-an-accountable-care-organization/

Just another idea from bureaucrats to make us work more for less money. What's the percentage chance that a hospital or other big health care entity is going to cooperate with private physicians, share costs and end up reducing their utilization and piece of the pie? (Hint: I am thinking of a number lower than zero). They'll just buy up some local practices and run their own show.

Not to worry though, just like the rest of the ACA, the ACO concept is already on life support and the Republicans are tugging at the plug.

Theoretically, ACOs make a lot of sense BUT
It will require that the hospitals change from a profit center to a cost center
That physicians become aligned to 1 hospital and not multiple.
That there is flow of information not just from hospital to MD but also reverse and to nursing homes, home health and other organizations that can provide care cheaper than in a hospital setting.
That providers are incented to work in this system. There is a loss of automony but it may be worth it if the system works better and the reimbursement is increased due to lower cost of care which goes back to the actual managers of the health care (the providers.)
The last issue is that it will only work if a large enough percentage of the patients are enrolled. It would work best in a single health care system but even with multiple payors, if the bulk of patients are in the system it has a chance.

There is a lot riding on it to prove it can actually have cost savings but each of these steps will be obstacles that need to be overcome.

Basically we'd have a lot of Kaiser-like entities, but likely headed-up by hospital systems, rather than MDs or a foundation. Scary.

In this bureaucrat's dream we'd all be employees of the hospital cause they'd run all the ACOs and only contract with employed physicians.

It'd be easy for all the big insurance companies to sign contracts with them and cut us independents out.

We should be lobbying to make sure ACOs are MD controlled and not hospital controlled. Also limit the ability of ACOs to cut out independent docs.

Maybe it'll die like capitation did, but maybe not...

L Wang
Solo Internist