ACO’s Compensate for Something Doctors Influence Not Control

In my previous post about the ACO Risks and Rewards, I suggested that providers do indeed take on a greater portion of risk in an ACO, but that also opens them up to larger reward possibilities as well. I think this is very much the case and will be an important aspect of healthcare going forward. Many are going to do very well with an ACO if they create the right partnerships.

However, that post on ACO risks and rewards didn’t address what could be physician’s biggest concern with ACOs. This concern is that the ACOs will compensate doctors for something that they they only influence as opposed to control.

Jim Brule, a past healthcare CIO, provided a good summary of this challenge on a LinkedIn thread that I started asking if EMRs were harder to use than paper as was asserted by Anne Zieger in the article linked. Here’s Jim’s comments about ACOs:

I think ACOs – in principle – provide the structure necessary for value-based healthcare. However, a lot of work is necessary to ensure that any given ACO is structured to actually reinforce better outcomes.

One of the key components of that is patient engagement, which many providers are nervous about, as it means tying their compensation to something they influence, not control. I understand their concern, but believe that we need to move in that direction.

It’s definitely a challenge to the ACO model, but like Jim Brule I think we need to and will move in that direction anyway. Jim Brule did also offer what might be the key to allaying physician concerns over an ACO:

Ultimately, though, we can’t do this without good, actionable information – and you’re not going to get that from paper – or free-text notes, electronic or otherwise.

One of the biggest trends we’re going to see in healthcare over the next five years is going to be around data with MUCH of that data coming from the EHR. Some will call it business intelligence. Others will call it data mining. Others will call it big data. I think there’s a few other names out there, but at the end of the day it’s all about taking this voluminous amount of healthcare data and making it actionable and produce results.

Nothing will depend on big data in healthcare more than an ACO. Those vendors who are able to make that data actionable are going to do very well and healthcare costs will benefit from the ACO as well.

About the author

John Lynn

John Lynn

John Lynn is the Founder of, 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.