ACOs: Here to stay or gone tomorrow?
With the recent announcement by CMS that nine of the 32 Pioneers were dropping out of the program there has been much “Sturm und Drang” about the passing of ACOs into obscurity. A recent article in the Investor Business Daily has gone as far as to predict that not only are all ACOs going to fail, but while in existence they “will diminish the quality of care received” by Medicare patients.
Seriously? Is anyone buying this stuff? Think about it. The program, Pioneer and MSSP, has improved beneficiary access to services, and allowed better coordination of services. This is achieved by ensuring that patient information is shared among caregivers, which improves joint decision making between a care giver and the patient about treatment options. If it all goes according to plan, there should be a reduction in the cost trend because the elimination of unnecessary procedures or treatment results in less “stuff” to charge for. But even if savings do not materialize, isn’t the prospect of earlier diagnosis and better treatment outcomes just as good of a result?
Interestingly enough, I do not recall any of the Pioneers who dropped out suggesting that they would stop their efforts at coordinating care or encouraging joint provider patient decision-making, etc.
What’s the point you ask? The point is that the underpinnings of the Pioneer and MSSP programs, i.e. providing the right services in the right setting at the right time for the right price, will survive the ACO and will serve as the legacy for all who participated in the program –stay or leave.
Those of us in the healthcare industry committed to the improvement of clinical outcomes while curtailing costs see ACOs for what they are. ACOs are one small step for service delivery engineering, and one giant incentive for continued health care practice reform at the provider and payer level.
So let’s stop wasting energy speculating whether, and or when ACOs disappear. The more important question is how do we build on the foundation that CMS has created with the Pioneer, MSSP and other demonstration programs designed to elicit service delivery and pricing innovations. Opportunity knocks.
Resources
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