The FINANCIAL — Providing a seamless, integrated system of care across a range of healthcare settings, accountable care organizations (ACOs) are increasingly being touted as the cure for a failing health system. But challenges remain.
Unlike the current fragmented model of healthcare provision, the ACO version is designed to enable and encourage healthcare providers to take greater responsibility for controlling the growth of healthcare costs for a given population of patients. By grouping together an ‘ecosystem’ of healthcare providers – such as a hospital, primary care physicians and specialists – ACOs aim to create a cohesive, clinically integrated framework that encourages accountability and creates incentives for providers to focus on coordinating a holistic approach to patient care.
President Obama's healthcare overhaul envisions hundreds of such networks around the county to lead a bottom-up reform of the country’s health system.
But whilst acknowledging the potential for such systems, a leading industry group representing premier organizations such as the Mayo Clinic, Cleveland Clinic and Geisinger Health System has raised concerns over plans for the system as currently proposed by the administration.
“We believe ACOs have the potential to transform the delivery system from a volume-based, fragmented system to one that focuses on care coordination, technology, team-based care and improved outcomes,” explained Donald Fisher, American Medical Group Association President, in a letter to the Centers for Medicare and Medicaid Services – the agency charged with rolling out the program.
However, Fisher added that the proposed regulations as they currently stand are “overly prescriptive, operationally burdensome, and the incentives are too difficult to achieve to make this voluntary program attractive”.
The AMGA represents 400 medical groups that provide care for about 100 million Americans, and the criticism represents a significant blow to the government’s plans to reform the healthcare system. The Obama administration had estimated as much as $960 million in savings from the first three years of the program, and bigger amounts thereafter, but commentators believe there is still much work to be done to realize that level of cost reduction.
“Don't underestimate the infrastructure that is going to be required for a successful ACO model,” said Benjamin Isgur, Director of PwC's Health Research Institute and a keen observer of the evolving ACO model.
“If you look at the rules, if you aren't already a fairly integrated organization, there are some pretty daunting things there,” Isgur said in a recent interview. “You have to have EMR working well so you can analyze the data. You are going to have to meet more quality requirements than any other CMS program. And you have to manage a population that might be difficult to manage because you might not know exactly who is in your ACO until after the first full year. There are a lot of infrastructure and sophistication issues that organizations should not underestimate."
Implementing the ACO model is no doubt one of the issues that will be discussed at the CFO Healthcare US Summit 2011, which takes place from 20-22 September at the Ritz Carlton Marina del Ray, in California.
This closed-door summit, hosted by GDS International, features some of the leading voices in the US CFO healthcare sector, including Philip Patterson, CEO of Bon Secours Health System; Leon Leach, EVP of the University of Texas MD Anderson Cancer Center and Chairman of the Board of Directors of MD Anderson Services Corp.; Michael Burke, CFO at NYU Langone Medical Center; and Grace-Marie Galen, President of the Galen Institute.
Along with streamlining patient flow, other key topics for discussion include ways to increase market share; the impact of health IT on cost and care quality; reducing waste in the healthcare system, and strategies for managing the cost-speed-quality cycle of clinical documentation.
CFO Healthcare US Summit 2011 is an exclusive C-level event reserved for 100 participants that includes expert workshops, facilitated roundtables, peer-to-peer networks and co-ordinated meetings.