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ACO Final Rule: 10 Healthcare Leaders Sound Off

HealthLeaders Media Staff, October 25, 2011

The risk-free track, elimination of the electronic health record requirement, the first dollar payment after the lower cost threshold is reached, "and the change from retrospective to prospective assignment make it easier for ACOs to keep track of how they're doing and better respond to the needs of their patients.

"These changes, will make it more likely providers will consider forming an ACO, and I believe more actually will, but you have to remember that this is not for the feint of heart; There is still a great deal of capital and infrastructure requirement."

6. Nathan Kaufman, president of Kaufman Strategic Advisers LLC:

"From an actuarial standpoint you need more than 10,000 lives, huge infrastructure, patients can still go wherever they want and the ultimate savings will come out of the pockets of specialists and hospitals. So why is this good? The best thing that could happen to a hospital or health system would be that your competitor developed an ACO."

7. Linda Fishman, senior vice president of public policy for the American Hospital Association:

(Asked if ACOs will go away if the Affordable Care Act is repealed) "The whole concept of accountable care, we believe, is here to stay. Whether the Medicare program participates in it or not, we have a number of hospitals across the country who have entered into ACO-like arrangements with private payers. So I do think the direction the healthcare system is moving is certainly toward accountable care....

"(But) if the Supercommittee (Joint Select Committee on Deficit Reduction) or efforts beyond the Supercommittee to achieve deficit reduction occur in the next several years, and choose to reduce market basket updates to providers, those are significant factors that would have to be figured into how you participate in the ACO.

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