Attention To Surgeons And Surgical Care Is Largely Missing From Early Medicare Accountable Care Organizations

The Affordable Care Act supports the growth of accountable care organizations (ACOs) as a potentially powerful model for health care delivery and payment. The model focuses on primary care. However, surgeons and other specialists have a large role to play in caring for ACOs' patients. No studie...

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Bibliographic Details
Published in:Health Affairs 2014-06, Vol.33 (6), p.972-979
Main Authors: Dupree, James M, Patel, Kavita, Singer, Sara J, West, Mallory, Wang, Rui, Zinner, Michael J, Weissman, Joel S
Format: Article
Language:English
Subjects:
Accountable care organizations
Case studies
Chronic illnesses
Cost control
Health care delivery
Health care policy
Health policy
Hospitals
Incentives
Interviews
Leadership
Legislation
Markets
Medical referrals
Medical service
Medicare
Patient Protection & Affordable Care Act 2010-US
Patients
Payment
Physicians
Primary care
Roles
Specialists
Studies
Success
Surgeons
Surgery
Surveys
United States
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Summary:The Affordable Care Act supports the growth of accountable care organizations (ACOs) as a potentially powerful model for health care delivery and payment. The model focuses on primary care. However, surgeons and other specialists have a large role to play in caring for ACOs' patients. No studies have yet investigated the role of surgical care in the ACO model. Using case studies and a survey, we examined the early experience of fifty-nine Medicare-approved ACOs in providing surgical care. We found that ACOs have so far devoted little attention to surgical care. Instead, they have emphasized coordinating care for patients with chronic conditions and reducing unnecessary hospital readmissions and ED visits. In the years to come, ACOs will likely focus more on surgical care. Some ACOs have the ability to affect surgical practice patterns through referral pressures, but local market conditions may limit ACOs' abilities to alter surgeons' behavior. Policy makers, ACO administrators, and surgeons need to be aware of these trends because they have the potential to affect the surgical care provided to ACO patients as well as the success of ACOs themselves.
ISSN:0278-2715
1544-5208
DOI:10.1377/hlthaff.2013.1300