ACOs on the Road
We discussed many of these change drivers with a few hundred attendees when we took the EDGE ACO presentation on the road to Boston, Nashville, Dallas, Denver and San Diego. Based on what we heard, I have little doubt that bundled payment will emerge as a major vector during this decade. I expect that when bundled payment and episode of care models are implemented by the Centers for Medicare & Medicaid Services (CMS), United Healthcare, Blue Cross and Blue Shield and other payers, they will serve to immediately drive major changes in care delivery, provider behavior and cost structures across the entire health care marketplace.
So where does that leave that overhyped reform buzzword, the ACO? During discussions with attendees at the "ACO road show," we heard almost universal hesitation or downright rejection around participation in the Medicare Shared Savings Program as outlined in the Patient Protection and Affordable Care Act, due to its multiple unknowns and financial uncertainties.
Since CMS published its Shared Savings Program governance draft, market skepticism has clearly grown and become more vocal. In light of this, the following messages emerged from our "road show" presentations.