MA Inches Toward ACO Model

How much further these experiments go depends as much on politics as on economics. 

The current push for payment reform is being driven by Governor Deval Patrick (D), who is up for re-election in November. His chief opponent, Republican Charlie Baker is no stranger to healthcare. Baker, former CEO of Harvard Pilgrim Health Care, names lack of transparency as the prime suspect in the high cost of medical care. He is viewed as favoring less government oversight than Patrick as a means toward controlling healthcare costs. 

Regardless of who wins in November, controlling healthcare costs hinges on three things that must happen more or less simultaneously: 

• Implementing some form of payment reform
• Defining guidelines for ACOs
• Negotiating the balance of power among government, providers, & payers

No doubt someone from the governor's office—and someone from the Baker campaign—will be dialed in to the OIG listening session next week on legal issues associated with ACOs.