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ACOs Can Work with Physicians in Charge | Study Looks at Effectiveness of a Primary Care-Led Accountable Care Organization

By Victoria Stagg Elliott, Amednews

A hospital partner may not be necessary for an accountable care organization to be effective, according to a report analyzing a primary care-led ACO.

Physicians increasingly are selling their practices to hospitals, which are buying in preparation for the development of ACOs and other aspects of health system reform. People who work in this area are holding up the subject of the journal’s case report — WellMed Medical Management in San Antonio — as an example of how an ACO can work without a hospital partner, serve more than the minimum 5,000 Medicare patients mandated by the Patient Protection and Affordable Care Act for ACO designation, and achieve positive results.

The impact of a primary care-led ACOLinksSee related content”WellMed is the only example I know of a primary care-based ACO. Most people are trying to tie ACOs to hospitals, and WellMed is a great example of how it can be done otherwise,” said Robert Phillips Jr., MD, MSPH, lead author and director of the American Academy of Family Physicians’ Robert Graham Center. The report was published in the January/March issue of The Journal of Ambulatory Care Management.

WellMed, which is organized around the medical home model, has 21 primary care clinics that serve thousands of people age 65 and older. The WellMed Medical Group has rheumatologists, dermatologists, cardiologists, hospitalists and podiatrists on staff, but all other specialty and hospital services are contracted out.

“It’s not a foregone conclusion that the successful ACO of the future is going to come out of a hospital or hospital system,” said F. Douglas Carr, MD, medical director of education and system initiatives at the Billings Clinic in Montana, a multispecialty practice that has its own hospital. It was not part of the WellMed study. Dr. Carr directed the 280-physician practice’s participation in the Medicare Physician Group Practice Demonstration. Information gleaned from the program formed the basis for ACOs’ inclusion in health system reform legislation.

Costs, hospital stays also cut

The case study documented that WellMed’s patients had a lower death rate than those in the same age group in Texas. Subsequent papers are expected to show notable reductions in the length of hospital stays and the cost of care.

“We feel that physicians can create organizations to manage care and control costs without a hospital,” said Gary Piefer, MD, chief medical officer at WellMed Medical Management.

The research, which was funded by…. (Read complete article at amednews).

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