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Could Health Plans Derail ACOs?



The reality is that everyone will protect their own interests, which has health plans knocking on doors in Washington, making sure federal agencies are aware that collaboration among already powerful healthcare providers under the ACO model also includes the risk of collusion.



3 comments on "Could Health Plans Derail ACOs?"
J. Kuriyan (10/28/2010 at 9:58 AM)

ACOs are nothing more than the PHOs & IDSs of the 90's - an Avatar of a system that failed for many reasons. There are new lawyers and young Professors promoting the concept. We must be aware of the history or .... None of the reasons for failure have been corrected. Why should it succeed now? As for Direct contracting, except in some very closed communities dominated by one provider network, employers rejected the notion in no uncertain terms. Employees wanted the privilege to access any and all providers - and employers didn't see any reason for denying them. Meg Whitman-borrowed Gov. Schwarzenegger's definition of insanity applies here - "doing the same thing over & over, hoping the results will be different this time."
Mike D'Eramo (10/28/2010 at 8:27 AM)

The ACO does provide a means for the consumer to be reengaged into the health financing process. We have allowed the modern health plan to evolve into a non-value added third party that does not benefit patient, provider, or employer. However, the employer/patient dyad must ensure that providers are fully disclosing quality and cost data as part of their access process.
Kevin Lieb (10/27/2010 at 2:59 PM)

ACO's, if done right and as they mature, could eliminate the need for Health Insurance. The doctor is absolutely correct. In theory, you buy insurance to cover risk whether its for your car/home/or health. But if that risk is now pushed to the doctors, via capitation, why do you need an insurance company? They're just skimming off a percentage of revenue for little to no added value. If I ran an ACO and felt that I could take on risk I would go directly to the employers in my town/county and eliminate the middle man - insurance companies. Direct contracting makes much more sense that our healthcare insurance system.