How can healthcare organizations that were built on volume adapt to the arrival of a value-based reimbursement system? American providers, as well as payers, are struggling to find an answer to that critical question. When it comes to the Accountable Care Organization (ACO), the struggle generally takes two forms: either to jump in with both feet via a model such as the Medicare Pioneer ACO program, or to sit back and take a wait-and-see approach.
This paper explores the unique perspectives of both types of organizations. The participants include two of the original 32 Pioneer ACOs; the nations largest commercial ACO; a major IDN that is pursuing its own ACO pathway; a large stand-alone hospital that has yet to take the formal step of creating an ACO but is experimenting with the model; and a large, independent, multispecialty physician group that is wary of stepping into the ACO waters.
All six organizations are Allscripts clients who participated in presentations on this topic before their peers, including at the American Medical Group Association annual conference in March, 2012. Taken together, their views describe the opportunity, the challenge and the promise of building a functional ACO.