The coming year could be the year when “accountable care organizations” (ACOs) get a chance to show whether they will be a fad or a classic.
Health care analysts at PricewaterhouseCoopers L.L.P., New York, have listed the upcoming test of the ACO concept as third item on their list of the top 2011 health industry issues.
“Is this the next big thing or not?” the analysts ask.
An ACO is a vehicle for paying teams of health care providers to care for whole patients, instead of paying for care one service at a time.
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In the past, the federal government tried to hold down rising health care costs by imposing strict limits on health care providers’ financial relationships with other providers.
The Affordable Care Act, the legislative package that includes the Patient Protection and Affordable Care Act (PPACA), is requiring Medicare to use ACOs starting in 2012, and many private health carriers are now testing ACOs.
Many health care and health insurance organizations are preparing to participate in ACOs in 2011, the PricewaterhouseCoopers analysts report.
“While ACOs hold great promise for reduced costs and improved quality, the challenge will be keeping people in the ACO and engaging them to stay healthy, which could be the difference between profit and losses,” the analysts say.
PricewaterhouseCoopers has found evidence that ACOs will have to take the time to determine which consumers are willing to get their care from ACOs and which are not, the analysts say.
Elizabeth Mills, a senior counsel in the Chicago officer of Proskauer Rose L.L.P., a law firm, ACO organizers still face regulatory challenges.
Federal regulators recently organized a public ACO workshop, and