"I don't think there's any question that mid-levels—premium mid-levels, nurse practitioners, physician assistants—are going to have to play a vital role in this process," Stone adds. "You already have too few doctors. A lot of doctors do things that mid-level (nurses) are perfectly capable of doing. Just as I wouldn't hire a super-talented physician recruiter and pay them a lot of money to have them do data entry, it's the same concept. We are starting already to see the volume pick up of mid-levels being hired in anticipation of those changes."
When asked how physicians will be brought into the ACO, 75% of executives replied that most incoming physicians are likely to become employees of health systems. Only slightly more than half—51%—say that their current staff has all of the characteristics to be successful in an ACO model.
Of those participating in the survey, whether they actually will be joining an ACO is still a major question mark. Of the 244 participating hospital and healthcare-hiring executives, about 57% indicated they have no plans to become an ACO to their knowledge.
"I was surprised to see that number, I thought it was high. I think there continues to be hesitation, a kind of wait and see," Stone says. "Is Romney going to repeal the whole thing, or isn't he?"