10 Things You Need to Know to Succeed and Be Happy in an ACO

Leigh Page

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July 28, 2015

In This Article

10. ACOs Will Survive and Thrive

Many physicians are asking whether it's worthwhile to get deeply involved in ACOs. Not only have most ACOs failed to earn bonuses, but they're also part of the Affordable Care Act, which Republicans vow to repeal if they take over all branches of government in 2017.

The medical directors' answer is plain and simple: ACOs are sticking around, no matter what. Even if ACOs were canceled, they would emerge under another name. These medical directors are also optimistic that most ACOs will eventually get on track and make money.

If and when the Republicans take over, "they're not going to get rid of ACOs," Dr Pogue says. "They meet aspirations for fiscal conservatism. They can preserve the Medicare program without busting the federal budget."

But even if ACOs were abolished, Dr Dera expects they'd be replaced by something very similar, because the bloated healthcare system needs a value-based approach. "What it will be called 10 years from now doesn't matter," he says. "Even if it's not an ACO, it will focus on value. A cost-saving mechanism will be needed, no matter what."

In the event that ACOs were removed from Medicare, "commercial insurers and employers will carry the idea forward," Dr Dera adds, noting that NewHealth recently signed an ACO contract with Humana covering about 7000 of its managed care members.

In fact, Medicare ACOs now account for only a fraction of total ACO activity. According to a new analysis[11] in Health Affairs, 132 different payers had signed ACO contracts as of January, and Medicare accounts for less than one third of ACO-covered lives.

"The lessons we've learned through the ACO would apply to whatever new systems would be coming our way," Dr Habis says. "They've opened physicians' eyes as to how much money is being wasted."

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