Considerations for ACOs in Consolidating Markets

Accountable Care News

Douglas A. Hastings, Chair Emeritus of the Firm based in the Washington, DC office, wrote an article titled "Considerations for ACOs in Consolidating Markets."

Following is an excerpt:

Most policy influencers today believe that the first phase of accountable care already is over and that transformation to payment for value will accelerate, not slow down. Many experienced ACO providers are pushing to get to full risk fast. For a period of time, providers will be managing the difficult balance of being paid a mixture of fee-for-service and value-based payments. Their ability to influence the pace of that change and stay balanced while investing for the future will determine their success.

Shared savings likely is not a long-term model. Nor is traditional "market share" growth alone, given antitrust constraints and changing markets. What may be sustainable is a carefully-executed shift by providers over time to providing high value health care (which by definition includes lower costs and incentives to keep patients healthy) to designated populations on a global fee or capitated basis.

Nearly 200 new Medicare and commercial ACOs formed in last year. There are over 600 ACOs now in operation, covering over 18 million lives, including more than 350 Medicare ACOs and 250 commercial ACOs. The majority of the Medicare ACOs are physician-owned.