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Thoughts on Reform: When ACOs, Vectors, and Spin Collide

Michael Silver, PhD, Vice President, Sg2, for HealthLeaders Media, June 16, 2011

These first 2 pilot functions will likely produce more clarity around how to implement a more accountable, more integrated provider organization. At the same time, other emerging payment models such as bundled payment will likely overshadow the singular market focus and fascination with the "ACO as a destination." Market-validated ACO values such as tighter physician integration and standardized care protocols will likely be adopted by most hospital-centric Systems of CARE. ACOs must continuously be seen by the health care marketplace as important drivers of positive benefits and outcomes. To that end, they exist in the health care "spin zone" and influence reform dialogue.


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For example, on May 17, 2011, CMS announced the ACO Pioneer Program to facilitate the evolution of 30 Medicare Shared Savings Program participants into a broader population health management organization. The ACO Pioneer Program has targeted a potential health care savings of $430 million over 3 years, although during that same time frame, US health care expenditures will likely approach $8 trillion. Value-based purchasing metrics and other quality initiatives will also drive improved financial and clinical outcomes, with ACOs ultimately only a piece of the solution.

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