Question: Why Did Anyone Ever Believe in ACOs?
The evidence reviewed above suggests that components of accountable care organizations have limited and uncertain impact, especially on cost savings, and thus provide little support for the two postulates mentioned above: that better care coordination will improve quality at any given cost, and that the organizations will lower Medicare’s rate of spending growth.
Lawton Burns and Mark Pauly in Health Affairs.
I concur. Im not sure why anyone thought that ACO’swould lower Medicare’s rate of spending growth.
Valid point. I dont think that the ACO plan was thought through very thoroughly.
Most of the researchers trying to reform health care don’t actually understand the role of incentives and neither understand or believe in free markets. They try to achieve what they perceive would be the desirable result through regulation rather than competition. If you analyze what competitive firms look like, you will not achieve the same results by regulating hospitals to look like competitive firms — because they won’t be competitive firms.
I quote this from the article, perhaps this illuminates on the reason why ACOs are having such a hard time, “Care coordination and information technology are proving more complicated and expensive to implement than anticipated, providers may lack the ability to implement these mechanisms, and primary care providers are in short supply.”
“As in the 1990s, success depends on targeting specific populations, such as people with multiple chronic conditions who need and may benefit from coordinated care.”
If they do it better, it might work.
Any plan where bureaucratic efficiency is key to success..
I concur with the above. ACOs targeted towards specific patient groups might prove useful.