A Push for Collaborative Care Calls ACO Models into Question
In January 2012, 32 healthcare organizations became the first to participate in the Medicare Pioneer Accountable Care Organization (ACO) model. Now, over a year into the initiative, as many as 9 organizations are in deliberation of leaving the program.
In January 2012, 32 healthcare organizations became the first to participate in the Medicare Pioneer Accountable Care Organization (ACO) model. Now, over a year into the initiative, as many as 9 organizations are in deliberation of
Unlike the SSP,
Some Pioneer ACOs are considering the SSP, because unlike their current business model, it offers an option that poses no risk of financial penalties for the first three years. However, in exchange, there are fewer opportunities for higher return on reward.
Presbyterian Healthcare Service’s President and CEO, Jim Hinton, says their ACO is debating continued involvement because of concerns about geographic variation that could affect incentives. “Medicare's Pioneer program does not lock patients into the ACO's provider network,” Mr. Hinton said, “yet ACOs still are responsible for the quality and cost of patients' care. The CMS data needed to track performance was delayed.”
Medicare Pioneer ACOs must make their decision to continue participation by July 31.
Despite worries, there is still a strong demand for coordinated care that will drive cost savings and increase quality patient care nationally.
Dr Jeffrey Brenner, founder and executive director of the Camden Coalition of Healthcare Providers, said current healthcare delivery models need to revamped. Dr Brenner,
New Jersey Health Care Quality Institute President and CEO, David Knowlton, adds that there may be challenges to building successful ACOs, especially in creating incentives that will drive members of ACOs towards desired outcomes. “There is no question that the ACO could be a wonderful opportunity in collaborating hospitals and the delivery system,” Knowlton said. “It could also harm hospitals. If those incentives are not properly aligned, it won’t work.”
The future of directing collaborative care through ACOs will be determined by finding an effective delivery model that balances incentives with risk, and continues to push practitioners towards better quality, cost-effective care.
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