A terrific op ed in the Wall Street Journal questions the viability of many of the ACOs being “spurred” by the Accountable Care Act. The article suggests that many such ACOs are doomed to fail.
Says the op ed, “The first untenable assumption is that ACOs can be successful without major changes in doctors’ behavior.”
Further, “The second mistaken assumption is that ACOs can succeed without changing patient behavior.”
“The third and final flawed assumption of the Affordable Care Act is that ACOs will save money.”
Good “accountable” health systems exist today because accountability is in their core culture. Converting a fee-for-service-driven system to an ACO can succeed but will require huge cultural changes…huge…throughout the entire system, and some internal disruption. I’ve seen systems convert successfully. But, just painting on an ACO veneer won’t do it.
This is a good and timely read. Click here to read the full article.
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Tom Emerick
Coming soon: Cracking Health Costs, the book, to be published by John Wiley & Sons. The authors are myself and Al Lewis. Click here to pre-reserve at a deeply discounted price.
Tom Emerick is the President of Emerick Consulting, LLC, and Partner and Chief Strategy Officer with Laurus Strategies, a Chicago-based consulting firm, and cofounder of Edison Health. Prior to starting his consulting career, Tom was with Walmart Stores, where his last position was Vice President, Global Benefit Design, which involved designing and managing benefits for over 1.3 million employees in the U.S., and 300,000 plus in international. For about six years, Tom also headed up Walmart’s Six Sigma and process improvement initiatives. Prior to Walmart, Tom had positions with Burger King Corporation, British Petroleum, and American Fidelity Assurance Company. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare the US for his work on medical ethics. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever.
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Tom, I couldn’t agree more. The changes necessary in a reformation of a busted system are the human changes. Docs need to change their culture, away from a culture where doing more medicine means more money in their pockets. Then as my Canadian friends tell me, get away from a culture of spoiled Americans who want what they want, when they want it and how theey want it. As long as we keep throwing more slop in the troughs, American healthcare consumers (overconsumers really) will keep coming to feed at the troughs. The ACA will not save more money – noy for any foreseeable future. There’ll be so much confusion and bureaucracy, the thing will become a typical government black hole.
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