Doctors Rush To Obamacare's Accountable Care Approach
Nearly
one in four doctors are in or planning to link with an accountable care
organization within a year, a new Medscape study shows. AFP/Getty
Images The number of physicians participating in the emerging medical
care delivery system known as “accountable care organizations” (ACOs)
has tripled as…
Bruce Japsen, Contributor
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4/27/2013 @ 12:30PM |21,284 views
Doctors Rush To Obamacare's Accountable Care Approach
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Nearly one in four doctors are in or
planning to link with an accountable care organization within a year, a
new Medscape study shows. AFP/Getty Images
A new study from Medscape said one in four doctors, or 24 percent, “were either in an ACO or planned to be in an ACO within a year.” By comparison, only 8 percent of physicians in Medscape’s 2012 report were in or planning to be in an ACO. The report included more than 21,000 doctor respondents across 25 specialties.
“There’s a dramatic change in the number of physicians who are becoming involved in Accountable Care Organizations,” the report said. “The focus on ACOs as a care-delivery and cost-containment method is making an impact.”
ACOs, which reward doctors and hospitals for working together to improve quality and to control costs, need doctors to be a quarterback of sorts in using nurses and other caregivers to manage the medical-care of populations of patients.
ACOs link medical care providers together to improve quality. If the providers in the ACO achieve better outcomes, they divvy up money saved with the health plans.
“ACOs are being looked to as one of the tools for lowering the cost of healthcare,” said Leslie Kane, executive editor of Medscape Business of Medicine.
“ACOs can encompass new payment models for certain health conditions, such as bundled payments,” Kane added. “In a bundled payment, the ACO receives one set payment for a particular patient’s ‘episode of care.’ And whichever doctors see or perform services on that patient, they will all share in that set payment.”
The Medscape report is different than others of late in that it looked at physicians. A report earlier this year from consulting firm Oliver Wyman said the ACO approach is also gaining momentum among U.S. consumers, employers and insurers, saying more than half the U.S. population has access to ACOs.
ACOs last year began providing medical care services to seniors through contracts with the Medicare health insurance program for the elderly. In addition, most private health insurance companies, too, such as those operated by Aetna AET +0.23% (AET), Cigna CI +0.14% (CI), Humana HUM +0.6% (HUM), UnitedHealth Group UNH +0.24% (UNH), Wellpoint (WLP) as well as Blue Cross plans linking with ACOS to care for more patients.
Earlier this week, the New York Times followed up on a story the newspaper wrote about a year ago that featured an effort by Blue Cross and Blue Shield of Illinois that is achieving some success in how it pays a Chicago-based healthcare system. Advocate Health Care is reducing hospital admissions, the insurer and provider said.
A health plan contracts with doctors and hospitals through an ACO which pushes high quality, less expensive treatment rather than today’s payment system that often leads to excessive treatment by paying for each procedure that isn’t always necessarily better. The providers in an ACO are responsible for managing the care of the health plan enrollees and are financially rewarded if the enrollees, or patients, stay out of the more expensive hospital.
“Another reason the government is promoting them is that there is the strong hope that they will improve coordination of care for patients, so that it may cut down on duplication of tests, etc.,” Medscape’s Kane said. “There is also the opportunity with ACOs that if the organization comes in ‘under budget’ for its patient care, physicians will be able to share in the profits that are available. Many areas are racing to set up ACOs, and doctors feel that if they don’t get into them, they may get shut out of a potential patient pool.”
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