Many physicians opt to participate in accountable care organizations to maintain independence and meet CMS' reporting requirements. Medical Economics delves into physician-led ACOs' ins and outs and the benefits providers may accrue from this model.
Here are five things to know about physician-led ACOs:
1. New England Journal of Medicine recently published a study that found ACOs which independent primary care groups led yielded more savings than hospital-led ACOs.
2. Sue Feldman, RN, PhD, an associate professor at the University of Alabama at Birmingham, conducted research on ACOs and told Medical Economics these models have various benefits compared to hospital-led ACOs. Dr. Feldman said physician-led ACOs can shop around for services such as diagnostic testing, which hospitals cannot do.
3. Physician-led ACOs reap bigger savings as they can better reduce emergency department and hospital admissions. Matthew Bates, senior leader with Pensacola, Fla.-based Studer Group, a healthcare consulting firm, said to Medical Economics, "It's tough for a hospital to tell its physicians to use its emergency department and hospital less."
4. Hospital-led ACOs are often infused with layers of bureaucracy, which may delay the decision-making process. Physician-led ACOs can identify a problem and solve it relatively quickly. Glen Allen, Va.-based MD Value Care, a physician-led ACO, is one such example in which the ACO developed a program where care coordinators contacted discharged patients to schedule follow-up appointments and review medications. Ken Zelenak, MD, the ACO's medical director, said they can "fill in holes" based on conversations with their groups' representatives.
5. Medical Economics reports next steps for ACOs entail getting the patients on board. An ACO can put all the tools in place, but if a patient engages in unhealthy behavior like smoking, the ACO cannot reap its greatest possible success.