Rugged individualism: Declining reimbursements lead to ­innovative programs

While the regulators tinker with the rules surrounding the accountable care organization (ACO) model they've put forth to im­prove healthcare quality and control costs, hospitals, health systems, and their representatives have spent copious amounts of lobbying and public relations energy on helping make sure that tinkering is to their advantage, or, at least, that it doesn't cost them more to achieve the designation than it will save.