"Speaking for ourselves—the things we do in quality, safety, patient-centered care, and patient satisfaction—all of those are the right things in the long run for the patient. However, they may not be the right things for us in the short run financially," he says. "We look at organizations, whether they be government or insurance companies, and we might not feel they have the same shared values that we do. There's concern about what could be done to us [unilaterally] as opposed to what we could do collaboratively to improve."
That sense of victimhood in the race to improve healthcare cost and quality might tinge the responses to a question about accountable care organizations. Responses to that question indicate that 49% believe their organization will be part of an ACO within three to five years. Of that group, 58% will be part of either the Medicare Shared Savings or CMS Pioneer programs, while only 18% expect to be part of a commercial insurer's ACO structure.
Those responses are interesting given perceived lack of interest in the Medicare ACO program when its proposed rules came out last spring. The survey closed just a day after CMS released its final rules, which received a more positive reaction than the earlier proposal.
For his part, Kolosky says the new rules do make the prospect a little more interesting.