First National Survey of Accountable Care Organizations: Half Are Physician-Led

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<p>In the new issue of <em>Health Affairs,</em> researchers at the Dartmouth Institute for Health Policy and Clinical Practice and the University of California, Berkeley, report findings from a Commonwealth Fund–supported survey of accountable care organizations (ACOs) across the nation—the first study of its kind. Also in the new issue, researchers analyze spending patterns among younger dual eligibles with mental disorders to identify factors associated with higher spending.</p><p><a href="/publications/journal-article/2014/jun/first-national-survey-acos-finds-physicians-are-playing">First National Survey of ACOs Finds That Physicians Are Playing Strong Leadership and Ownership Roles</a>,<strong> </strong>by<strong> </strong>Carrie H. Colla, Valerie A. Lewis, Stephen M. Shortell, and Elliott S. Fisher. "In spite of initial concerns about potential hospital dominance, physicians are at the forefront of leadership in the early implementation of the ACO payment and delivery model," say the authors of this study of 173 private and public accountable care organizations across the United States. According to the survey, just over half of ACOs are physician-led, while another one-third are jointly led by physicians and hospitals. While physician-led ACOs may face challenges in managing care across settings, their greater focus on outpatient care compared with hospital-led ACOs may allow them to achieve sharper reductions in the use of costly inpatient or postacute care.</p>
<p><a href="/publications/journal-article/2014/jun/factors-associated-high-levels-spending-younger-dually">Factors Associated with High Levels of Spending for Younger Dually Eligible Beneficiaries with Mental Disorde</a>rs, by Richard G. Frank and Arnold M. Epstein. "Dual eligibles" under age 65 typically qualify for Medicare because of a disability and Medicaid because of low income. In this study, researchers found that within this population, those with mental disorders incur nearly twice as much in health care costs as those without any. According to the authors, better case management to coordinate medical, mental health, and substance abuse services could yield substantial savings—particularly for Medicare, which covers 60 percent of all spending for nonelderly dual eligibles with mental disorders. The federal government, they say, should consider gain-sharing arrangements whereby states with effective care coordination programs are able to receive some portion of any Medicare savings generated through better dual-eligible care.</p>