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Disruptors

Most accountable care organizations, regardless of if they are formed by hospitals, health systems or physician groups, are primary-care based. After all, patients are generally attributed to ACOs based on their primary care provider.

Cigna has joined forces with physicians affiliated with Boulder (Colo.) Community Hospital's Community Medical Associates to launch a collaborative accountable care initiative, the payer's version of an accountable care organization.

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.

Optima Health, Norfolk, Va.-based Sentara Healthcare's health plan, and Johnson City, Tenn.-based Integrated Solutions Health Network, an affiliated company of Mountain States Health Alliance, have formed an accountable care organization network in southwest Virginia.

After CMS announced 106 new Medicare accountable care organizations in January, only 35 new commercial ACOs have been announced, according to a Health Affairs blog written by David Muhlestein from Leavitt Partners.

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Some of the nations biggest retailers have been rapidly expanding into the provider space, including Wal-Mart. Retail health clinics may prove to be hospitals' most capable competitors in the years to come, particularly since chains like Wal-Mart have already demonstrated…

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