With a common goal, why then will there be different models? The best definition of an ACO I have found thus far was part of a recent brochure that crossed my desk, announcing the first National Accountable Care Organization Summit to be held this summer.
ACOs are provider collaborations that support the integration of groups of physicians, hospitals, and other providers in different ways around the opportunity to receive additional payments by achieving continually advancing patient-focused quality targets and demonstrating real reductions in overall spending growth for their defined patient population. The ACO model is highly flexible and can be organized in a number of ways—ranging from fully integrated delivery systems to networked models within which physicians in small office practices can work effectively together to improve quality, coordinate care and reduce costs. They can also feature different payment incentives ranging from “one-sided” shared savings within a fee-for-service environment, to a range of limited or substantial capitation arrangements with quality bonuses.
It is the hope of the U.S. government, in order to halt the growth of our health care costs, that ACOs will provide a transition from our fee-for-service mentality—paying for volume and intensity—to rewarding providers for enhancing value, which requires improving quality while simultaneously reducing costs.
The degree to which ACOs will be successful yet remains to be seen. But clearly, their goals to incent integration and coordination of care and minimize fragmentation of care are absolutely the right ones and must be achieved if health care reform has any chance of success.