By Daniel J. Vukelich, AMDR
Earlier this week, HealthLeaders Media addressed the Top 10 Clinical Integration, ACO Physician Questions. Noting that physicians may be skeptical of new ACO arrangements, want to know how ACOs will impact their patients, and frankly how doctors will get compensated, the authors list the top ten most frequently asked questions about clinical integration (CI) and accountable care organization (ACOs). At the top of the list, “Is this really going to happen?” HealthLeaders reports:
Yes, the term “ACO” is new since 2007, but the concept on which it is based is not. Some physician organizations have been functioning as ACOs for many years. CI as an organizational goal has been pursued for decades, and guidance has been available from regulators since 1996 on how to use CI as a contracting model for independent physicians. There is no question that the country needs to improve its coordination, quality, and efficiency of care. CMS intends for ACOs to work or will change/replace the ACO framework with another plan for improved coordination. CI/ACOs will emerge, or providers will find that they will become a commodity with ever increasing expectations by consumers and ever-diminishing price paid per unit of service.
And, at number 10, “What’s in it for me?”
By actively participating with CI programs and ACOs, physicians will not only be included in contracts with payers that might otherwise exclude them, but will also have the opportunity to participate in the development of protocols for their network of providers as well as the governance of these organizations. They will receive reports and prompts to help manage their individual patients and the populations of patients they serve, supported by care managers with the tools to help patients maintain or return to health. Branding of the organization will help to enlarge their practices and to broaden the populations they care for. Other benefits to be expected would be: being part of a high quality healthcare delivery system, feedback that the physician is doing the right thing (i.e., providing accurate and timely care), and increased satisfaction with one’s career choice.