ACOs Are Here to Stay. They will vary in form, but not function

I just returned from the Second National Accountable Care Organization Congress. It was a three day conference focused on discussing the role that ACOs, public and private, will play in the movement to reengineer how healthcare services are delivered, evaluated, priced and paid f or.

The speaker panels consited predominately of public and private policy wonks discussing the shifting dynamics in regulatory attempt to drive healthcare reform and providers sharing their positive results in delivery  sytem reenginnering efforts, including ACO and medical Home development initiatives.

Attendees to the conference were primarily physician organizations, some hospital organizations and the typical collection of consultants. The mood at the conference was both sober and decidedly upbeat.  Sober because everyone recognized that the status quo was no longer an option going forward and upbeat because the underlying tenets of ACOs, i.e. Coordinated care, Stakeholder collaboration, greater patient engagement,improved information sharing, etc. were principles that everyone could support and use as drivers for healthcare delivery system reform.

The overriding themes that I took away from the conference are summarized below. Suffice it to say that all of us who work within the healthcare industy and who are committed to creating an approach to healthcare delivery that is sustainable both clinically and financially, recognize that much needs to be done and that ACOs are but one tool in that journey.  We at Gorman Health Group believe it is a journey worth taking.

The themes from the ACO Congress that I believe resonated with most attendees were:   

1. ACO concept is here to stay and will flourish in one form or another
2. ACOs will not all look alike. If you have seen one ACO you have seen one ACO. Commonalities will be collaboration, value based payment, patient engagement, attention to quality metrics, etc
3. ACO development will be driven by the private sector, not by the government
4. Collaboration amongst the stakeholders, (patients, providers and payers) is key to ACO success, it is key to system reengineering
5. Trajectory and end point for payment reform will be global payment. The  question is when, not if
6. Patient centered medical homes are a core construct of an ACO, not an adjunct
7. Collection, analysis and sharing of information is critical to improved, more efficient care
8. Team based medicine is here to stay and will be the driving force for improvement of care quality
9. Information, the collection, anlysis and reporting out, will be critical to any delivery system reengineering efforts
10. And last but very important there was general agreement that CMS/CMMI significantly exceeded provider expectations regarding the positive changes to the shared savings program as reflected in the final rule.