NEW YORK CITY – A recent report published by the Institute for Health Technology Transformation gave some interesting insight into accountable care organizations (ACOs). Among sections focusing on the origins of the ACO concept and their current state, the report detailed 10 basic things you need to know about ACOs.  

1. A physician's role will change dramatically. "The economics of patient-centered care will create significant financial incentives for doctors to do more to coordinate care - most importantly, increase collaboration with other medical professionals," the report read. And in addition, this collaboration, according to the report, will occur within the confines of firm, evidenced-based medicine. "...Physicians will be incented to work in patient-centered, evidence-based practices, interfacing with other physicians and care providers to optimize the patient's health at the lowest possible cost."

2. Patients must be engaged in their care. The report stated ACOs build a competitive edge by engaging patients in the delivery of their healthcare. "ACO models propose patient engagement in decision making that requires consideration not only of the best scientific evidence concerning medical treatment, but also the opportunity for patients and their families to assess prospective treatment approaches in light of their own values and convictions." ACOs promote this type of patient engagement as well as possession of basic knowledge for the patients. This enables them to maintain good health, all while avoiding preventable medical conditions and knowing how to manage existing conditions. And, eventually, this will cause accountability to extend beyond the ACO and into the general public.

3. ACOs will create winners and losers among providers. The report cited Harvard business professor Clayton Christensen and said ACO models can be thought of as disruptive business models. "These disruptive models will need to create alignment of interests of the individual doctor and the team, and all will share accountability when patient care goals are not met." Therefore, for ACOs to be successful and sustainable, they must compete for consumers. "Successful ACOs must give consumers a value proposition that is competitive locally, nationally and globally," the report stated. "Providers that are not accountable and transparent will 'lose,' and those that meet patient needs and improve care will 'win.'"

[See also: ACOs adopting different payment approaches under PPACA, says report.]

4. ACOs are a team sport. According to the report, today’s siloed patient care approach won't function in a world of accountable care. In fact, an effective transition to an environment that’s more patient-centered and information-rich requires leaders to become informed consumers of the products of improvement science. "These new approaches will change the way the physicians interact with patients, payers and other clinicians," the report read. "While there will be examples of ACOs established by physicians in isolation from hospitals and health plans, this may not be the ideal approach. The reality is that physicians, hospitals, health plans, and many other healthcare stakeholders each bring unique skills and experiences to help deliver accountable care."

5. Transparency will empower consumers and motivate providers. The report makes clear it’s not possible to have accountable care without having at least one party that the healthcare system is accountable to. "In the case of ACOs, the assumed beneficiary has traditionally been the federal government," the report stated. "Since accountable care models are supposed to save money by doing a better job of coordinating care and making wise treatment decisions, the government (and thus the taxpayer) is better off as a result." But, this view doesn’t reveal the whole story, said the report. In fact, it's the consumer that stands to benefit the most from regulations that improve transparency. "Since providers differ widely on cost and quality, widespread adoption of quality measures is likely to improve patient access to this information."

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