As posed by Jonathan Bush, President & CEO of AthenaHealth in a superb interview by Matt Holt, aka @boltyboy on Twitter (thanks again, Matt!), at the HIMSS 2011 annual conference in Orlando last week, A/C/O development for some institutionally led ACO initiatives is merely ‘code’ for the license to roll-up, or otherwise acquire physician practices.
‘Danger Will Robinson, Danger!’
However, from lessons of the not-to-distant past, watch when your institution ‘marries’ your physicians’ checkbooks. A funny thing seems to happen on the way to ‘strategic nirvana’ envisioned by ‘me too’ or cookie cutter integration formulas.
Yet, courtesy of the FTC, and DOJ, financial integration in order to assume risk, legally set price, align incentives and better manage medical resource utilization, is not the only glidepath towards ACO formation. For a background piece courtesy of Donald R. Moy, Esq., Michael J. Schoppmann, Esq. & Mathew J. Levy, Esq. Kern, Augustine Conroy & Schoppmann, P.C., click here.
In fact clinical integration on the surface if not in deep into the mechanics of its transformational DNA affords a rather compelling rationale to leave ‘cowboy’ or solo practice medicine behind and foster the care coordination, aka group practice culture, so essential to shift to a population based ACO care management paradigm (see reasoned speculation by Katherine Rourke ‘Do You Need An EMR To Make ACOs Work‘? My answer: yup)!
In the clinical integration scenario, health information from a community-wide perspective, is the ‘secret sauce’ that brings independent i.e., mainstream medicine, into the care coordination and better resource management conversation; a far less threatening and disruptive proposition to the prevailing practice paradigm in the US today.
For detailed indicia of clinical integration, see the 2007 FTC advisory opinion letter issued to the Greater Rochester Independent Practice Association, Inc.