ACOs seem to be the next great hopeful for health care cost containment, but I have yet to read anything very optimistic about them. Writing them into Healthcare reform without actually defining them seems to be leaving a great deal of opportunity for the entire sector to spin it's wheels on ways to cope with it.
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I don't blame industry stakeholders for being reluctant to get on the ACO train. This seemingly abstract label creating all this buzz is not an entirely new concept with low-cost, high-quality integrated delivery systems aka "ACO-like" models such as the Grand Junction (Colorado) and Mayo Clinic (Minnesota). However, HCR may be prematurely putting the pressure on physicians and hospitals to reorganize in 2012, especially given that only a few existing demo sites have shown modest results in shared savings. I thought this ACO roundtable video from the New England Journal of Med provided a good perspective that sheds some optimism as well as caution (and it just so happens one of the panelists, Dr. Elliott Fisher from Dartmouth coined the ACO term, so it was neat to hear him talk about it)
http://www.nejm.org/doi/full/10.1056/NEJMp1009040
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