Presented by: Forming ACOs


Fearful the ACO market will be small, healthcare players are competing to be first. Providers are moving quickly to form ACOs because of the concern that there won’t be room for many players in the field.


It’s not a small task, as you can imagine, to move from a system where you’re organized and paid one way and not fully integrated, to another model entirely where you’re assuming responsibility for a group of patients across the continuum of their care.


Diane Pinakiewicz, National Patient Safety Foundation


For many healthcare providers, forming an ACO requires a substantial reorganization. Provider groups experimenting with reimbursement systems based on outcomes are a few steps ahead. The Act requires an ACO to assume responsibility for the care of at least 5,000 Medicare beneficiaries. Those forming an ACO must create a structure that integrates providers to coordinate and manage all of the care for the patients assigned to it.


Many healthcare players seem determined to act fast, based on the concern that there won’t be room for many players in the ACO market. Consequently, hospital systems, academic medical centers, and insurance companies are competing to be the first in their market to form a credible ACO. Until the federal government issues final regulations, however, it’s hard to know exactly what they should look like and what will be required of them.


Copyright © 2011 by A.M. Best Company, Inc. All rights reserved. No part of this report may be reproduced, stored in a retrieval system or transmitted in any form or by any means; electronic, mechanical, photocopying, recording or otherwise.


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