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ACOs called key to doc payment reform

MANAGED CARE January 2013. © MediMedia USA
News & Commentary

ACOs called key to doc payment reform

Nearly 52 percent of doctors are familiar with the term “accountable care organization” and half of those say that their practice is already participating in one or expects to, says a working paper by UnitedHealth Group. “[I]nterest in participating was notably higher among PCPs — 55 percent of PCPs familiar with the term were pursuing or planned to pursue the option, compared to 38 percent of specialists,” says the working paper “Farewell to Fee-for-Service? A ‘Real-World’ Strategy for Health Care Payment Reform.”

Shared-savings and shared-risk arrangements that would have to be implemented to make ACOs viable appeal to some policy makers because they break with what they consider to be the perverse incentives of the fee-for-service system. “While most P4P programs offer relatively modest bonuses to individual providers that are based on a defined set of indicators within their scope of control — such as hospitals’ rates of infections or primary care physicians’ appropriate use of screening tests — shared-savings and shared risk programs typically offer incentives to a group of providers that reflect total population quality and costs,” says the paper.

As we’ve reported, many experts are less than convinced of ACOs’ potential (http://tinyurl.com/Herzlinger). The UnitedHealth Group report says key issues need to be addressed, including how patients are assigned to ACOs, who comes up with the expenditure targets, how might they be achieved, how quality will be measured, and how savings will be distributed. “Deeper issues include how providers are going to reorganize their practices to improve care delivery and control spending, and how to limit the risk of cost increases stemming from an increase in the market power of providers.”

Physicians’ familiarity with and interest in forming or joining an ACO

Are you familiar with the term accountable care organization? If so, is your practice considering joining or forming an accountable care organization?

Source: “Farewell to Fee-for-Service? A ‘Real-World’ Strategy for Health Care Payment Reform,” UnitedHealth Center for Health Reform & Modernization, December 2012