WIHI: Pioneering ACOs: What Do We Know So Far?

Date: September 27, 2012

Featuring:

• Elliott Fisher, MD, MPH, Director, Center for Population Health, Dartmouth Institute for Health Policy and Clinical Practice
• Palmer “Pal” Evans, MD, former Senior Vice President & Chief Medical Officer, Tucson Medical Center (TMC)
• John Friend, Vice President Business Development & Associate General Counsel, TMC Healthcare; Executive Director, Arizona Connected Care, LLC
  
  

One of the best-kept secrets about US health care this election season is the degree to which change and transformation are coming, no matter what happens in November. You won’t hear “global payment” or Medicare Shared Savings Program mentioned as often as “individual mandate” in the current political debate, but ask anyone leading a health care organization today which issue keeps them up at night, and it’s definitely payment reform. In general terms, the entire system is shifting from paying for volume – lots of procedures – to paying for value, or how well patients are cared for over time and across the continuum.

Accountable care organizations (ACOs) are one critical new reflection of this migration, and they’re being encouraged by public and private payers alike. What do we know about the more than 200 ACOs that have formed in the US thus far? It’s still early in the process, but some smart people are keeping a close eye on ACOs, and we’re going to be talking with a few of them on WIHI.

As Director of Population Health and Policy at the Dartmouth Institute for Health Policy and Clinical Practice, Dr. Elliott Fisher is leading a major study of the factors enabling ACOs to get up and running and to successfully implement new forms of care delivery. WIHI host Madge Kaplan welcomes Dr. Fisher to the show to share what he and his team of evaluators have learned thus far. He’ll be joined by leaders from Tucson Medical Center, one of the nation’s earliest adopters of the ACO concept. Dr. Palmer “Pal” Evans and John Friend from Arizona Connected Care both say that one of the biggest hurdles for newly forming ACOs is to let go of the notion that hospitals can and should run the show. That’s not where the future is headed, both say, and they’re learning this in spades in Arizona. They’re also learning how to build will and buy-in from mostly independent physicians, a situation that’s typical of most US hospitals.

There are plenty of uncertainties ahead, but Elliott Fisher, Pal Evans, and John Friend agree that ACOs or something similar are likely to be a feature of reform for the forseeable future. They share their perspectives and answer questions on WIHI.

For some background on Tucson Medical Center’s entrance into the ACO experiment, please take a look at these Commonwealth Fund case studies published earlier this year.