ACOs Seen As Tough Sell, Despite Concessions

John Commins, for HealthLeaders Media , October 24, 2011

"My first selling point is there is a non-risk option for you to gain some experience without significant downside," he says. "Yes, you might have to make some significant investments. But the world is heading in this direction and we are going to be more accountable for the quality and the cost of the care we deliver."

"Here they are saying 'we will look at your current costs and if you can improve on them you will get some shared savings back. And by the way we will even do it in a non-risk fashion. Over three years if you get more savings you get 50% of that back," he said.

As for alienating specialists, Spahlinger says that the push to keep people out of the hospital is going to go forward with or without ACOs. "CMS is going to pull a bunch of levers over the next five years to try to reduce readmissions and inappropriate care and they are going to micromanage it even if you don't go into this ACO model," he says. "This model allows you to say what our current costs are, we improve upon it and we get 50% of it back."

See Also:
Medicare ACOs Move Closer to Commercial Model Under Final Rule
ACO Final Rules Ease Requirements, Reduce Risk
Two-Tiered U.S. Healthcare System Looming

John Commins is a senior editor with HealthLeaders Media.

Comments are moderated. Please be patient.

2 comments on "ACOs Seen As Tough Sell, Despite Concessions"

Tim Richardson (12/1/2011 at 8:10 AM)
Since patients can directly access any provider, including sub-specialists, under ACOs many will attempt to claim that they are providing "primary care" for certain high-risk populations: Endocrinologists may try to become the primary care provider for diabetics. Physiologists may try to provide "primary care" for older people and Orthopedic or neurosurgeons may try to provide 'primary care" for people with arthritis. Tim Richardson, PT

Jennifer N (10/25/2011 at 11:18 AM)
Since ACOs are a hard sell, they must prove to be a financially sound opportunity. They should reflect a model that will allow patients to understand that a hospital cares about not just their bottom line, but most importantly, their health. In hospitals, ACOs may be implemented by C-level execs and medical directors...but from the patient perspective, accountable care is delivered through the face of the care [INVALID] the physician. Therefore the physician must represent the ACO movement in a positive light in order for them to be integrated and successful. Many physicians are not yet on board with all ACO models, so providers implementing the models will have to first realize that they need their physicians to be in agreement that this will benefit their patient community. I saw a great video from OptumInsight that explains the importance of physicians being on board with ACOs:




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