I’ll admit that I’ve been a little slow to grab onto the ACO movement that’s happening. As most who read this blog know, I’m a tech person by training and experience and so some of the hospital dynamics generally aren’t as interesting to me when they don’t relate in some way to technology. When I first heard the discussion about ACO’s I kind of put it in that general hospital workings box and didn’t care to talk about it much.

However, the ACO terminology keeps coming up over and over again. Plus, I’ve seen a number of headlines in passing that talk about the potential need for EHR software to make an ACO possible. Not to mention, I’m almost certain that someone at HIMSS is going to ask me what I think about ACO’s and I like to look reasonably well educated about important healthcare topics (with ACO’s being one of those this year).

I found one NPR article that talks about some of the details of ACOs that I found interesting. Although, they probably summed up the challenge of understanding ACOs in this sentence, “ACOs have been compared to the unicorn: Everyone seems to know what it looks like, but nobody’s actually seen one.”

That gives me cause for concern. I’m a very practical and hands on kind of person. Not that I can’t catch the vision of where the future might lie, but I generally find it hard to follow something that doesn’t have a reasonable path towards actual execution.

So, I’m reaching out to my readers to help me understand ACOs. How will they be developed? Will they spawn from other entities? Are they just a pipe dream that will never become reality? Is this a failed business model from the start which will end badly?

Then, of course I’m interested in what any EMR companies are doing to prepare for the needs of an ACO. What role will an EMR play in an ACO? Will it be the key to the accountability part of an ACO?

What other things am I missing when it comes to ACO?

As is often the case, the comments on this will be more valuable than the post. I look forward to learning from you.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference,, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • The way I understand it, a group of physicians (ideally a relatively large group), usually regionally-based, will coagulate to form a large pseudo-hospital. It’s basically what people often do already, given that you’ll often find that certain physicians always refer to certain physicians, but beyond the referral there’s no real system in place to take advantage of this/make it easier on the patients. The idea of the ACO is to create a “system” for tracking patients, etc.

    Unfortunately I feel like because of how vague the term is, actual implementation will differ on a case-by-case basis, and no one has actually come up with a really good one. I mean, who actually lords over the ACO system itself, who’s making the decisions on who’s in and who isn’t, etc. and who’s going to be paying for the ACO anyways? A large reason for private physicians being private is because they want more control than being in a corporate practice, but that’s by default contradictory to the concept of ACOs. After all, NATO is NATO, but arguably the US is really the chair-nation. How’s it going to be for ACOs, unless they’re intending to hire a third party, for example?

    So my perspective is that it’s a chic term to throw around but no one really has an idea of how to actually pull it off. It just sounds nice. Friendly doctors! Collaboration! Saved costs! Increased efficiency!

  • Interesting topic, but not relevant to to the subject of EMRs per se, except that such an organization would undoubtedly use the same cloud-based product.

    This HMO look-alike is an attempt to control costs, at the expense of a degree of practitioner independence. Still not addressed are the main drivers of health care costs — 1) third-party insurance (no personal stake in restraining costs), and 2) malpractice insurance sans tort reform.

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