Fam Pract Manag. 2011 Nov-Dec;18(6):8.
ACO costs may outweigh savings
Regarding “What Family Physicians Need to Know About ACOs” [September/October 2011], at least three organizations are trying to create accountable care organizations (ACOs) in the southeast Connecticut area. Although ACOs have the potential to improve quality and continuity of care, they will be a major cultural change. In addition, the logistical, administrative and actuarial support costs are likely to be a constant drag on the bottom line and, in my opinion, are very likely to eat up any cost savings. If we move toward ACOs, I fear we will be trading today's inefficient system for a system in which the real producers of care, primary care physicians, are relegated to the rank and file in a top-heavy administrative bureaucracy driven by contractual requirements. Any value added will be absorbed administratively, and we will find ourselves doing a better job and rendering better care but with less control and certainly less income.
The gorilla-size loophole in the ACO model is that patients are “assigned” to a practice and their health care costs are attributed to that practice; however, the patients have no obligation to follow the advice of the doctors in that practice! In fact, the patients do not even know they have been assigned to a practice. They can receive medical care from any source they choose, including a practice that is much less efficient and more costly than the one being held accountable for their care.
WE WANT TO HEAR FROM YOU
Send your comments to firstname.lastname@example.org. Submission of a letter will be construed as granting AAFP permission to publish the letter in any of its publications in any form. We cannot respond to all letters we receive. Those chosen for publication will be edited for length and style.
Copyright © 2011 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact email@example.com for copyright questions and/or permission requests.
Want to use this article elsewhere? Get Permissions
More in FPM
Related Topic Searches
MOST RECENT ISSUE
Access the latest issue
of FPM journal
The Adolescent Health Consortium Project has clarified clinical preventive service recommendations for adolescents and young adults.
Here's how to succeed in the four performance categories of the Merit-based Incentive Payment System.