Accountable care organizations (ACOs), legal partnerships between doctors and hospitals that provide financial incentives to providers for more efficient and better care, will be part of Medicare by 2012 and are attracting wider interest among commercial payers and state legislatures. According a January 27, 2011 article in the New York Times, ACOs receive a lump sum payment to cover care for a specific population of patients and are able to keep any savings resulting from meeting performance goals. Patients are assigned to a particular ACO, but are not restricted to receiving care from providers in a particular network, unlike managed care in the past. Experts believe ACOs are a promising model for improving costs and efficiency, and that their more proactive approach to care could lead to improved health outcomes, but they shouldn’t assume patients will go along with changes, HSPH’s Meredith B. Rosenthal told The New York Times.
“Patients don’t really want to hear that you’re going to save money for the providers,” Rosenthal said. “They want to know that if they get care here, there will be some value for them.” One way to get around suspicion and build loyalty could be to charge patients lower co-payments if they stay within their group of providers, she said.
Patients’ Role in Accountable Care Organizations (New England Journal of Medicine editorial co-authored by Rosenthal)
Video interview with Rosenthal on the 2010 health reform law (HSPH website)