Physicians as Full ACO Partners: The Ideal Model?

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Many of the established accountable care organizations have been formed by hospitals and insurance companies, with those executives having the final say in ACO-related matters.

However, this may not be the ideal ACO model, according to a recent Harvard Business Review blog post by Robert Pearl, MD, executive director and CEO of the Permanente Medical Group, and George York, MD, treasurer of the Permanente Medical Group.

"A hospital-led system will fail when it tries to increase physician productivity or modify individual compensation," the authors wrote. "Physicians resist change, especially when they see their physician leaders in subordinate roles."

Instead, physicians should be full partners in ACO activities, the authors argue. This can be achieved by structuring the ACO as a nonprofit organization with a governance model that includes hospital, health plan, medical group and community representation.

In other words, physician members of the ACO work with the hospital and/or health plan, instead of working for them, and all ACO member organizations share in the financial risks and rewards of the model, according to the authors.

The main benefit of this ACO model is that "it aligns the goals of patients, hospitals, health plans, purchasers and physicians," the authors wrote. "Attaining this alignment produces high morale and commitment to improved performance among the ACO's physicians."

More Articles on Accountable Care Organizations:
Integrated Solutions Health Network, Optima Health Form ACO
3 Reasons ACO Growth Has Slowed
9 ACO Implementation Challenges

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