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Physicians Lead Most, Best ACOs

Jacqueline Fellows, for HealthLeaders Media, June 26, 2014

The transition to value-based healthcare requires strong physician leaders. Physician engagement is the most critical factor for ACO success. But financing and working across the care continuum are challenges for physician-led ACOs.

An accountable care organization (ACO) in Palm Springs, FL, could very well be a model for designing a successful physician-led ACO. This format accounts for a more than half of the ACOs operating now, according to survey results published this month in Health Affairs.

Palm Beach ACO, one of the first to be part of the CMS Medicare Shared Savings Program, was one of 29 ACOs that generated enough savings to merit a bonus payment. It received an $11 million bonus for generating $22 million in Medicare savings. Like most of the other MSSP ACOs that received a bonus payment, Palm Beach ACO is led by physicians. It's also owned and operated by physicians, a characteristic that the Health Affairs article points out is increasingly common.

Study shows most ACOs run by docs
The study authors, who are primarily affiliated with the Dartmouth Institute for Health Policy and Clinical Practice, surveyed 173 ACOs, including those established through CMS, Medicaid, or commercial payers, and found that 51% of respondents self-identified as being led by physicians. Thirty-three percent indicated leadership was jointly held by physicians and hospitals. Just 3% said they were hospital-led only; 13% said they were led by another entity. In addition, the survey noted that physicians held the majority of board positions across various ACO types, whether physician or hospital-led.

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