Bullish on ACOs

April 24, 2013 by InTouch Health

Accountable Care Organizations and telemedicine have a common purpose: expanding access to improve care. According to a recent CDC report, 80% of adults who visit the ER do so because they lack access to other providers. Telemedicine not only provides that access, but it makes it easy to provide the post-visit patient monitoring so vital to the ACOs’ main mission: managing high-risk populations.

Telemedicine-driven ACOs hold a lot of promise, but that didn’t stop several Harvard University pundits from prematurely proclaiming their demise.

In a recent Wall Street Journal article titled “The Coming Failure of Accountable Care,” Harvard prof Clayton Christensen and colleagues painted a gloomy picture. But they were quickly countered by Joseph Kvedar, MD from the Center for Connected Health. After careful reflection, we agree with Dr. Joe.

In Kvedar’s view, the Harvard gang incorrectly labels ACOs as “latter-day health maintenance organizations.” But HMOs were driven primarily by health plans that lacked the tools for delivery reform. In contrast, ACOs are provider-driven, offering a fresh vision for population-based care delivery and reimbursement.

The Harvard gang feels that doctors’ attitudes won’t change enough to make ACOs successful. But Kvedar notes that many physicians are weary of the fee-for-service grind, and are very receptive to things like shared savings, bundled payments and full capitation.

However, Kvedar and the Ivy Leaguers agree on one key point: to fulfill the promise of ACOs, patient attitudes must dramatically change. Many Americans still don’t feel compelled to hit the gym and avoid the cheeseburgers to rein in the cost of preventable, chronic illness. Millions of us cling to a sedentary lifestyle, then expect the healthcare system to fix us. That mindset will obviously have to change for ACOs to have a fighting chance.

Christensen and his Harvard associates are like baseball fans who write their team off in May. But, hey, the season is still young – and both telemedicine and ACOs have bright prospects. Dr. Kvedar feels that they could be the healthcare equivalent of the Baltimore Orioles: an unexpected success. Telemedicine-empowered ACOs can win the hearts and minds of physicians – and they can make money.

As every sports fan knows, you just have to believe.

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