Toward High-Performance Accountable Care: Promise and Pitfalls

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<p>In a new <a href="/blog/2010/toward-high-performance-accountable-care-promise-and-pitfalls">blog post</a>, Commonwealth Fund President Karen Davis, Ph.D., and Executive Vice President for Programs Stephen Schoenbaum, M.D., discuss the promise and pitfalls of accountable care organizations (ACOs)—a relatively new type of provider organization that is responsible for a population of patients across the continuum of care. Under the Patient Protection and Affordable Care Act, ACOs will be incentivized to play a more prominent role in caring for Medicare beneficiaries.</p>
<p>In their blog post, the second installment in a series on health care financing, Davis and Schoenbaum call on the Centers for Medicare and Medicaid Services (CMS) to test at least three ACO delivery system models:</p>
<li>patient-centered medical home networks, with shared funding and support provided by states, private insurers, or Medicare; </li>
<li>multispecialty physician group practices, with Medicare, states, and private insurers partnering to provide information and support as needed; and </li>
<li>health and hospital systems involving some combination of salaried physicians, physician practices, and group practice contracts, with insurers either a part of the health system or a partner in sharing risks and providing value-added services.</li>
<p>They also encourage CMS to consider five promising payment models that offer increasing levels of shared savings and shared risks through bundled payments.</p>
<p>"The ACA specifies the broad framework for creating ACOs, but whether the promise of this new payment and delivery model is realized will depend on safeguards to avoid some of the pitfalls that have plagued past efforts, implementation decisions made by CMS, and the willingness and ability of the health care provider community, other payers, and the general public to respond to this opportunity," the authors say.</p>