It seems that most hospitals are either not ready or not interested in participating in an accountable care organization (ACO). According to a report published by The Commonwealth Fund, 13% of hospitals are participating in, or planning to participate in, ACOs in the next year, and 75% of hospitals say they are not considering joining an ACO at all. 
ACOs are a care delivery system that gained a lot of attention with the passage of the Affordable Care Act. An ACO is a provider organization that takes responsibility for coordinating care for a patient population across the entire healthcare continuum. As of summer 2012, 154 groups are participating in ACO initiatives sponsored by the Centers for Medicare and Medicaid Services (CMS). An ACO can be an all-inclusive healthcare organization or a group of individual providers. Those who participate in an ACO are eligible for incentive payments that reward providers for efficiently managing patients, providing quality care, and preventing costly hospital admissions. Although the majority of hospitals are not interested in ACOs, many are still implementing the population management and care coordination principles that the ACO model promotes. Nearly 20% of hospitals that are not exploring the ACO model have population-based care management strategies that target high risk patients. More than half of those non-ACO hospitals are also sharing clinical information between care settings (67.3%), providing patient discharge summaries to their providers (61%), providing patient discharge summaries to primary care providers (67%), and identifying patient who transition between settings of care (64%). Clearly even hospitals that are not interested in joining ACOs see the value in improving communication with other providers and focusing efforts on high risk patients. This is likely a response to pay for performance initiatives such as the Readmission Reduction Program and the Hospital Value-based Purchasing Program set to take effect this fall. The study’s lead author, Anne-Marie Audet, M.D., told Kaiser Health News “We’re really still at the very beginning of the adoption curve of the ACO model. The challenge is that hospitals are still not ready to assume financial risk.” That notion is further supported by the fact that 52% of the hospitals that are part of an ACO are paid under the shared-savings model, which allows participants to share in the savings the ACO achieves without incurring any financial risk. Perhaps as hospitals become better at patient population management and care coordination, they will be more willing to join an ACO.
ACOs are a care delivery system that gained a lot of attention with the passage of the Affordable Care Act. An ACO is a provider organization that takes responsibility for coordinating care for a patient population across the entire healthcare continuum. As of summer 2012, 154 groups are participating in ACO initiatives sponsored by the Centers for Medicare and Medicaid Services (CMS). An ACO can be an all-inclusive healthcare organization or a group of individual providers. Those who participate in an ACO are eligible for incentive payments that reward providers for efficiently managing patients, providing quality care, and preventing costly hospital admissions. Although the majority of hospitals are not interested in ACOs, many are still implementing the population management and care coordination principles that the ACO model promotes. Nearly 20% of hospitals that are not exploring the ACO model have population-based care management strategies that target high risk patients. More than half of those non-ACO hospitals are also sharing clinical information between care settings (67.3%), providing patient discharge summaries to their providers (61%), providing patient discharge summaries to primary care providers (67%), and identifying patient who transition between settings of care (64%). Clearly even hospitals that are not interested in joining ACOs see the value in improving communication with other providers and focusing efforts on high risk patients. This is likely a response to pay for performance initiatives such as the Readmission Reduction Program and the Hospital Value-based Purchasing Program set to take effect this fall. The study’s lead author, Anne-Marie Audet, M.D., told Kaiser Health News “We’re really still at the very beginning of the adoption curve of the ACO model. The challenge is that hospitals are still not ready to assume financial risk.” That notion is further supported by the fact that 52% of the hospitals that are part of an ACO are paid under the shared-savings model, which allows participants to share in the savings the ACO achieves without incurring any financial risk. Perhaps as hospitals become better at patient population management and care coordination, they will be more willing to join an ACO.
