How does an accountable care organization save money? It becomes more efficient, care is better coordinated, there is less duplication of services, less unnecessary care and in the end there is higher quality care.
But if all that is going on, who is making less money; physicians, laboratories, hospitals, imaging centers, who? Supposedly, providers will benefit from sharing in the savings but we have to ask, how is receiving a portion of the savings you generate better than retaining 100% of the fees you charged before the savings?
In other words where is the incentive for providers to get involved in all this? The answer lies in this paragraph from the physician section of a large ACO’s website. In other words, a half a loaf is better than none. What they are saying is that if we all stick together, we will have better leverage in negotiating fees. What they are thinking is, once we get past this drive to lower costs and reach efficient levels, fees will start rising again.
Fee-for-service is under pressure, physicians have to react. This is exactly what happened in the 1980s with the rush to HMOs. The question is will the result be different this time around. Let’s hope so.
“An ACO provides the infrastructure to document and improve your performance along with the resources to maximize reimbursements in these new contracts. Those physicians not involved in ACO’s will likely see continued reductions in fee-for-service reimbursements.”
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