Riskless ACOs may invite abuse – Modern Healthcare

The hope that accountable care would rapidly diffuse across the healthcare landscape to help reduce costs suffered another setback when federal officials last week admitted few Medicare ACOs are ready to assume financial risk.

To keep existing ACOs from dropping out, the CMS proposed an expanded menu of incentives to keep hospitals and doctors involved while postponing when providers would actually face potential losses for three more years.

The move left some ACO advocates fearful that providers may simply wind up taking advantage of the program, even as they applauded the government’s efforts to keep hospitals and physicians involved.

“It makes sense to allow them more than three years to develop the capabilities and the confidence to control spending,” said Dr. J. Michael McWilliams, an associate professor of health policy at Harvard University. “It is a good idea to allow ACOs to evolve and develop infrastructure.

”It’s hardly what the Obama administration expected when it launched the Patient Protection and Affordable Care Act’s Medicare ACO program and set a goal for all ACOs to accept risk of losses after the first three years.

via Riskless ACOs may invite abuse – Modern Healthcare.

1 Comment

  1. Does this sound familiar? We heard the same battle cry in the 1980’s when capitation and gatekeepers were supposed to save us. Big Failure. Also the top-down “goals” (bribery vs. extortion) from CMS means ACO’s and providers will be more focused on compliance and/or gaming the system than about patient care. Again, it will be about checking off the right boxes. Hanging their hat on IT, Data analytics and coordinated care programs sounds nice, but where is the proof these save money. IT definitely doesn’t. Data, if applied in a targeted manner can help. Coordinated care is about communication mostly but it requires patient cooperation and very close follow up. That is the wild card. Everyone seems to leave the patient out of the incentive loop; until we find away to include them in financial rewards, this is going to be a tough sell.


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