A new report issued by Leavitt Partners suggests “accountable care organizations” are growing in size and scope, and will likely continue to pop up around the country whether the Supreme Court strikes down the Affordable Care Act later this month, or not.
Created as part of the Affordable Care Act, accountable care organizations are groups of hospitals, physicians, providers, insurance companies and community organizations that choose to form an “integrated care network” to serve a geographic area of patients. The incentive for forming these groups is a percentage of the savings generated for better coordinating care and creating better patient outcomes. Put another way, Medicare provider reimbursements are going to be cut, so form ACO’s to reap at least some reward for operating more efficiently. Medicare has announced 61 accountable care organizations that will serve Medicare beneficiaries, but this new report shows that more than 220 ACO’s have formed across the country by private entities.
The report issued five main points:
The number and types of ACOs are expanding. 221 ACOs in 45 states are testing multiple and varied models of sharing risk. This tally is up from 160 ACOs in 40 states identified in the November 2011 report.
Growth is occurring in large population centers, where multiple ACOs compete with each other.
Hospital systems sponsor the majority of ACOs, but ACOs backed by physician groups have seen the most recent growth.
The private sector is embracing new payment and care delivery arrangements. The presence of ACOs doing business among and between private sector payers and providers outnumbers that of the government sector by a factor of four to one.
Non-Medicare ACOs are experimenting with more diverse models than Medicare-backed ACOs.
The success of any particular ACO model is still undetermined.
Contact OPGA Government Relations with questions regarding accountable care organizations and how orthotics and prosthetics professionals can take advantage of the new, large referral sources in their area by focusing on data collection and documenting positive patient outcomes.