Asked what advice he might offer other organizations seeking to create accountable care models, Teitelbaum said, "we would advise strongly against a schizophrenic approach. By that I mean we do live in this world where we have the value/volume dichotomy, where we're torn in different directions."
But if an ACO is to be successful, he said, "you can't say let's treat this group of patients, for whom we're rewarded on a volume or transactional basis, one way, and let's treat a different group of patients, for whom we're rewarded based on clinical outcomes, a different way. We believe there is only one way, and you have to embrace value from the first."
John Smylie, Essentia Health CEO, agreed. "You can't be in two camps," he said. "And you have to bank on internal learning to carry you forward because no one's written the script for this yet. We are on the leading edge."
Teitelbaum was asked how Crystal Run persuades specialist physicians to be enthusiastic about an ACO.
"You bring them into the tent, rather than treat them strictly as vendors or outside contractors. You get them to understand, as primary care physicians do, the concept of value (and you ask them) do they really want to get paid at the end of the day simply for doing a procedure, or do they want to get paid for the outcomes they help create for patients. It's an educational process."
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