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Accountable care organizations take hold in Texas


The health system reform law Congress passed in 2010 seemingly established a new breed of health care delivery called an accountable care organization (ACO). But the concept of holding those who provide the care responsible for controlling costs while simultane- ously improving quality — with financial risks and rewards — is not entirely new, says Houston family physician Patrick M. Carter, MD (pictured at left). In fact, his multispecialty physician group practice, Kelsey-Seybold Clinic, has done it for years. Only this year was it formally recognized as the first — and so far only — ACO accredited by the National Committee for Quality Assurance (NCQA). While there is no single definition of


an ACO, it is loosely defined as a net- work of physicians, hospitals, or some combination that takes financial and clinical responsibility for a set popu- lation of patients and coordinates all of their care. In other words, instead of just selling the parts, an ACO sells the car. And payment would align with those goals, doing away with a com- partmentalized fee-for-service system. Over the years, there have been at- tempts at controlling costs and ensur- ing quality, albeit unsuccessful ones. Managed care and insurance compa- nies couldn’t do it, Medicare couldn’t do it, and hospitals can’t do it alone — without a physician network.


by AMY LYNN SORREL photography JIM LINCOLN


July 2013 TEXAS MEDICINE 19


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