Why Everyone Better Learn About ACOs

While I wasn’t working in healthcare at the time, I’ve heard a number of doctors say that doctors missed out on being part of the HMO process. Their voice wasn’t part of the process and they suffered as a consequence of that decision. As I consider that idea, I wonder if doctors aren’t in the same position again with ACOs.

I was reminded of this as I was reading through this whitepaper called ACO & Collaborative Care – The Basics. The whitepaper digs into a number of good ACO discussions, but I was struck by one of the opening phrases:

Health reform IS REAL and NOT GOING away.

That struck me, because I think many doctors are just hoping that this shift to ACOs and value based reimbursement will just go away. Certainly some of this hope is founded since ACO is such a nebulous concept and we’re not sure how it’s going to be implemented. However, just because a concept isn’t totally defined doesn’t mean that it’s not going to be the future of healthcare. I assure you that this shift in reimbursement isn’t going anywhere.

The fact that ACO is a nebulous concept is exactly why doctors should get involved in the process of defining an ACO. When there’s uncertainty, there’s opportunity. The question is whether the opportunity is going to be taken by doctors or by someone else. Ideally all parties will be involved and there will be a give and take. However, I think currently physician voices are underrepresented and they’ll suffer for it.

One other thing that the ACO & Collaborative Care – The Basics whitepaper points out nicely is that you can’t just go out and buy an ACO. There’s no off the shelf ACO solution that will solve your problems. It’s not a software. It’s not a program. It’s not an organization. It’s likely going to include all of those things and that means that it takes some planning, coordination and collaboration. You’re not going to be ready for it if you’re not part of the ACO conversation.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, 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, EXPO.health, 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.

1 Comment

  • As someone who was there pioneering the ‘disruptive innovation’ of the HMO ‘gold rush’, I might argue with the notion that docs where not involved in the process. Actually, they were quite involved both direct and via their management companies’.

    The difference today is twofold: 1) the % of GDP consumed by the healthcare economy is now no longer contained to private conversations inside of board rooms, as countries not just companies are at risk of bankruptcy, and 2) near ubiquitous access to technology and broadband fulfillment place unprecedented coordination and decisions support options and solutions before a desperate industry. And yes indeed, Healtheon (ref: Michael Lewis, ‘the new, new thing) was a bit ahead of it’s time.

    Independent Practice Associations (IPAs) were the breakthrough vehicle that allowed mainstream docs (previously most HMOs were of the ‘staff’ or ‘group’ model ie, Kaiser California, variety), to participate in managed healthcare/HMO medicine.

    Two pieces might be of interest: ‘Some Context on Standing Up the ACO’ may be of interest: http://acowatch.me/2013/03/29/some-context-and-perspective-on-standing-up-the-aco/ and ‘Standing up the ACO” A View from Ground Zero’

    And a particulalry timely piece was just posted by Farzad Mostashari, MD on the physician led ACO advanced payment model: http://www.brookings.edu/blogs/up-front/posts/2014/03/24-aco-advanced-payment-healthcare-aca-mostashari


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