“ACOs will implode just as capitated HMOs imploded in the 1990s,” Ms. Herzlinger said.
She points to inefficient electronic medical record systems, the difficulties in creating a team culture in an ACO and challenges in setting up public health insurance exchanges as reasons for why accountable care organization will not work. Ms. Herzlinger also says ACOs will create “severe antitrust problems.”
Her solution to concerns about the U.S. healthcare system is to push for “focused factories of care” where provider organizations would deliver highly specialized care for a certain group of patients — for instance, patients with diabetes or congestive heart failure would go to a provider organization highly specialized in caring for one of those chronic illnesses. Ms. Herzlinger distinguishes focused factories of care from ACOs in that the latter try to do “everything for everyone” while the former would be an extremely targeted care model.
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