Rise of the Accountable Care Organization

Change is coming to the healthcare neighborhood in the form of the Accountable Care Organization (ACO). ACOs have been cited by some as the savior of our healthcare woes, while others question the validity of this new government initiative.

What is an ACO?

An Accountable Care Organization is a network of diverse physicians who collaborate with each other to provide more holistic, coordinated healthcare to consumers. ACO creators promise increased quality of care while also managing to control costs.

Although the ACO provision only claimed seven pages in the expansive new healthcare bill that was passed, many claim ACOs have attracted the majority of consumer attention.

Why ACOs now?

With millions of baby-boomers approaching retirement age, our government is implementing the ACO concept as an attempt to minimize the inevitable soar of Medicare and Medicaid costs. Mark McClellan, MD, former administrator for the Centers for Medicare and Medicaid Services, stated that “ACOs are about fundamental changes” and that “the main emphasis is to get away from fee-for-service payment structures.”

What are the concerns?

Many experts believe that ACOs encourage consolidation and therefore, limit competition. Dr. Randall S. Bock compared the unfolding of ACOs to a real-world version of the board game Risk. This would be due to ACOs buying into some practices while ignoring others. Dr. Bock believes that these new larger entities can actually use their leverage with insurance companies to drive up costs, contrary to the primary goal of an ACO.

Can ACOs deliver?

Only the future can hold the answer to this question. There will be a variety of factors that will determine the success of ACOs. However, the end result is the most important aspect of this debate: patients deserve excellent care at low costs, regardless of the avenue taken.