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Survey: 50% of Hospitals Say They Have Financial Strength to Accept ACO Risk

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A survey of roughly 1,700 hospitals found 13 percent are either participating in or planning to participate in an accountable care organization in the next year, but only 50 percent of those reported that they have the financial strength and infrastructure to accept risk.

The report, "Hospitals on the Path to Accountable Care: Highlights from a 2011 National Survey of Hospital Readiness to Participate in an Accountable Care Organization," was written by the Commonwealth Fund and Health Research and Educational Trust.


Here are some other major takeaways from the survey, which was conducted from May 2011 to September 2011 and based on respondents from 1,672 hospitals.

• Of hospitals participating in an ACO, the top three challenges are reducing clinical care variation, reducing the cost of care and developing and maintaining a common culture among various ACO partners.

• Fifty-two percent of respondents reported pursuing a shared-savings model without risk of financial loss. Thirty-four percent of respondents are pursuing a shared-savings model with shared risk and 27 percent are pursuing global payments.

• Thirty-two percent were planning to apply for CMS' Pioneer ACO program, 16 percent for a Medicaid ACO and about 15 percent for the Medicare Shared Savings Program.

• The top challenges to participate in the Medicare Shared Savings Program, as cited by hospitals, are population attribution methodology (59 percent), shared savings payment model (58 percent) and antitrust policies (57 percent).

• Fifty-six percent of hospitals participating in or planning to participate in an ACO said they were pursuing an ACO contract with a commercial payor or self-insured employer.

• Of the hospitals planning to participate or currently participating in an ACO, the ACO will be/is a joint venture between physicians and the hospital for 51 percent of respondents and physician-led for 20 percent of respondents.

• Eighteen percent of ACOs have a physician-led governing body.

• Seventy-three percent of hospitals reported sharing clinical data among healthcare settings, including primary care practices, but only 35 percent have the ability to track whether the information exchange has been successful.

More Articles on ACOs:

7 States Establishing Medicaid ACOs
Pay-for-Performance or Pay-for-Manipulation?
5 Compensation Options for ACO Physicians


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