One Size Does Not Fit All for Payment Reform

“One size doesn’t fit all.”

Last week, during the MMS’ education program “A Path to Accountable Care Organizations: How Do We Get There From Here,” that concept for payment reform and ACO development was echoed repeatedly by several speakers.

The new paradigm that is emerging requires physicians and hospitals to cooperate and work together, taking advantage of each  entity’s unique factors.  Physicians provide a critical role in patient care as noted by our presenters, therefore their leadership remains essential to success.

Harold Miller, CEO of the Center for Health Care Quality and Payment Reform, cited examples from around the nation where small, independent practices are successfully collaborating to manage global payments.

He noted that various models of successful collaboration exist. He cited examples of small primary care practices, and independent primary care physicians and specialists, working together to manage global payments with full and partial risk contracts.  He also cited examples of joint contracting by physicians and hospitals for global payments.

Clearly, active engagement and participation of physicians, regardless of the size of their practice, IPA or medical group, is extremely important in the pursuit of better outcomes and lower cost.

Harold Miller  also stated that physician-hospital collaboration is not necessarily a zero-sum game:

To learn more about ACOs, accountable care delivery models and the things your practice can do to prepare please visit for more information.

– By Kerry Ann Hayon
Manager, MMS Physician Practice Resource Center

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