"I'm not sure it's possible, but it could be possible for us to participate now," he says. "Before [the revised rules] it was almost prohibitive. As a single-specialty tertiary center, we're in a different position, as we would not be the leader in the ACO, but a participant with another entity holding many of the pieces."
As for the reason healthcare has failed to solve its own problems, the majority (57%) cited too much self-interest among the different stakeholders. The next-biggest group, only 15%, were willing to blame healthcare's failures on a lack of incentive to innovate or deliver value. Kolosky agrees that innovation is needed, but says at his organization, senior leaders have embraced the fact that they need to be innovators.
"One of the things we spend a lot of time talking about from the leadership perspective is, how do we change?" he says. "We think that the things we need to do as an individual institution and as an industry really need to be transformational. So we think a lot about how to integrate personalized cancer care in our situation, for example. We also see huge opportunity in process excellence, or what some people would call Lean. We've made lots of improvements, and each one yielded huge opportunities, yet we've hardly scratched the surface."
This article appears in the February 2012 issue of HealthLeaders magazine.