Even those hospitals and health systems that seem well-positioned to benefit from an ACO structure (organizations that are effectively managing patients across the care continuum, capturing the metrics that allow them to understand their costs of care, and managing their own health plans) are still working on evolving and improving these core capabilities.
Healthcare executives are also acutely aware of a market-driven imperative for fundamental change to care delivery and payment structures — a movement from volume to value — and they must start making that transition while operating in a fee-for-service world. Most hospitals and health systems will need to reduce costs by about one-third in the future if they are going to survive, as many predict they will have to, on reimbursement rates that are no higher than Medicare rates.
ROUNDS: The Real Value of ACOs
When: August 16, 12:00–3:00 pm ET
Where: hosted by Norton Healthcare, Louisville, KY
Register today for this live event and webcast
So the question isn't whether healthcare organizations need to change, it's how to accomplish that change. As the pressures of healthcare reform mount, choices about how healthcare leaders spend their valuable resources of executive and organizational time and attention become more critical.
For most hospitals and health systems, there is a possibility that the opportunity cost of focusing on ACOs right now may not be worth the benefit that may accrue. Scarce organizational resources may be better used in making the fundamental kinds of improvements that our healthcare system so desperately needs — increasing quality and lowering costs.