ACOs as Food for Thought

The term Accountable Care Organization (ACO) seems to be everywhere these days.  It’s hard to pick up a health care journal, newsletter or newspaper that does not contain at least one reference to ACOs.

The one consistent thread is that ACOs are organizations of health care providers that agree to be accountable for the quality, cost, and overall care of ACO beneficiaries.  Industry thought leaders, physicians, administrators, and politicians are all buzzing about what the final CMS regulations on ACOs will look like.

Despite the fact that there has been a lot of concern voiced about the CMS proposed rule set, there has also been a lot of interesting discussion focused around using the ACO concept in innovative ways that ultimately promote CMS Administrator Don Berwick’s “Triple Aim” of better care, better health for populations and lower per capita cost.

A recent article in the New England Journal of Medicine, “A Model Health Care Delivery System for Medicaid,” by Dr. Richard Rieselbach and Dr. Arthur Kellermann, discussed the benefit of creating Community Health Center and Academic Medical Center Partnerships (CHAMPs) that would join together to form a CHAMP ACO.

The triple aim goal could be achieved for Medicaid patients by combining the strengths of teaching hospitals with those of community health centers, which would fundamentally be centers for the delivery of primary care.   Unfortunately, the proposed CMS rule set creates barriers for this type of ACO model.

If this phase between proposed and final rule making continues to stimulate innovative thought around models for high-quality, reduced-cost care, then perhaps release of the final rule should be delayed a bit longer.

To learn more about ACOs and the things your practice can do to prepare to become an ACO, join us on September 13 for our fall program A Path to Accountable Care Organizations: How Do We Get There From Here? Visit www.massmed.org/aco2011 for more information.

— Kerry Ann Hayon

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