The following New York Times article points out the difficulty in writing the law that will govern the new health reform legislation concerning Accountable Care Organizations.
I have been involved in a number of national initiatives trying to define the ACO concept. One of the efforts from NCQA released an 80 page document a couple of weeks ago which describes the thinking of a number of physicians, administrators and academics on the structure of the ACO. Unfortunately, as we define the structure of the ACO and how to accredit it we may be losing sight of the actual purpose for which it exists in the new law.
That purpose is to deliver more coordinated better quality lower cost care. The focus needs to be on the patient experience as the driver for design not how many hospitals or physicians can merge together. When we focus only on structure and finances we lose the power of what the ACO can really be. It is very disturbing the push to consolidate going on throughout the country. In my experience consolidation if not done for the right purpose does not lead to good things for the customer in this case the patient.
I could not agree more with Dr. Berwick's quote in the New York Times article. Here's the excerpt.
Dr. Donald M. Berwick, the administrator of the Centers for Medicare and Medicaid Services, hails the benefits of “integrated care.” But, Dr. Berwick said, “we need to assure both patients and society at large that destructive, exploitative and costly forms of collusion and monopolistic behaviors do not emerge and thrive, disguised as cooperation.”
To read the article, click here - http://www.nytimes.com/2010/11/21/health/policy/21health.html?_r=1&hpw
To read the ACO report, click here - ACO ncqaCriteria_Public_Comment1
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