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10 ACO Blunders You Can Avoid

Margaret Dick Tocknell, for HealthLeaders Media, August 17, 2011

This  promises to be a big week for healthcare reform - no, not in the courts - but in the regulatory realm. All eyes are on the Centers for Medicare & Medicaid Services, which is poised to release the final rules on accountable care organizations,

And Friday marks the deadline for organizations to apply to be part of the Pioneer ACO program. That's the special designation CMS has set up for healthcare systems that are already experienced in providing coordinated patient care. CMS hopes to have 30 Pioneer ACOs in place by later this year, 'all on an accelerated track to participate in shared savings.


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According to the HealthLeaders Media Industry Survey 2011, more than half, (52%) of physicians surveyed said they expect to be part of an ACO within the next five years. That survey, however, was completed months before the proposed rules were released in April.

'With upfront costs reportedly running in the millions of dollars, uncertainty about how much control anyone will have over their patient population, and concerns about meeting anti-trust requirements it's no wonder that ACO participation is still a big question mark for a lot of organizations.

This has to be white-knuckle time in CMS administrator Don Berwick's office. If the Pioneer ACO program can't attract health systems that are experienced in care coordination, how can it expect other groups to sign on?

Stephen Shortell, PhD, dean of the School of Public Health at the University of California, Berkeley, recently co-authored a commentary about implementing ACOs for the Journal of the American Medical Association.

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