Private Practice Insights: ACOs Gain Traction

By Stuart A. Bussey, M.D., J.D., UAPD President

With the majority of the Affordable Care Act blessed by the US Supreme Court, Accountable Care Organizations (ACOs) are now rolling down the runway.  Some have already launched.  Thus far 150 ACO contracts have been announced by Medicare with 400 more set for next year.  Despite the local power struggles between IPAs and hospital foundations many doctors are also treating commercial patients in ACOs (Blue Cross).  Medicare officials have relented to pressures and complaints by participating doctors by reducing the number of quality measures from 65 to 33 and by offering two payment options.

A major focus of an ACO is how to best manage complex patients (CHF, Diabetes).  Much of the problem in the past has been lack of care coordination.  A significant number of Medicare patients lack a primary care provider.  The major strategy will involve efforts to manage care between primary care and specialists. Whether this will translate into fewer hospital days and readmissions is the $64 question.