Frankly, that's a welcome change, as long as health systems don't unfairly dominate one market such that it has de facto control over reimbursement rates in a given area. It reflects an acknowledgement by hospital and health system boards and senior leaders that in order to make the most of the transformation of the healthcare business model from volume to value, systems must influence and even control how patients move through the entire healthcare system, such as it is, not just through an acute phase of care.
Much of this transformation is understandable. For years, many have been pushing hospitals to be more cooperative with other sites of care. But that's been a hard sell. Regardless of how you feel about coordination of care, hospitals for too long decided that if it happened outside their four walls, it wasn't their responsibility.
And after all, why should it have been? The way they were paid certainly didn't encourage coordination, and patient outcomes were not part of any payment equation. But now that's changing, and no one wants to be known simply as a "hospital" anymore.
If you want to create an ACO, which, let's face it, whether substantive or not, is the way to show the world that you are truly focused on the continuum of care, you need all these pieces and parts. And you need innovative leaders to run them. Sure, you can create effective care transitions without owning the pieces, but it's more complex, and the last thing most healthcare leaders want is more complexity on their daily calendars.