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ACO 101: ‘A Physician Primer’

Next week we take some time to get down to fundamentals for physicians on Accountable Care Organizations (ACO’s).

Specifically we’ll address:

  • What are they? Absent regulatory guidance, we have primarily a 30 thousand foot view with some pilot and demonstration exceptions.
  • What are the known or proximal models to date? How are they structured?
  • How will ACO’s impact medicine and my practice in particular? Is this Medicare and Medicaid only? Or will it impact the private market?
  • Why are ACO’s seen as a centerpiece in the Patient Protection and Affordable Care Act? Why the optimism?
  • What ‘go to’ resources are available, including related industry experience garnered from HMO’s, PPO’s and prior integrated delivery systems, to facilitate my education?
  • Why do ACO’s hold promise for taming the thirst of a seemingly insatiable health care financing and delivery ‘non’ system?
  • What does ‘physician leadership’ look like during the ACO consderation process?

Your advanced comments and questions are invited and welcome.

In a prior post, we supplied links to 3 timely and informative reports that are worth reviewing, click here for access.

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2 thoughts on “ACO 101: ‘A Physician Primer’

  1. Questions…

    For ACO network development – are their benchmarks for min-max # of enrollees per ACO PCP? How about the down-stream referral network composition – specialists, ancillary, and hospitals per 1,000 enrollees or similar metric.

    Thx – Pete
    Tampa, FL

    1. Hi Peter and thanks for the question. I believe that level of detail will be vetted during the rules process.

      Meanwhile, the most comprehensive source I’ve found to date is published by the Congressional Research Service. The abstract is here: http://opencrs.com/document/R41474/. You can download the complete report as a PDF.

      Really appreciate the comment!

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