Specialists and ACOs: Play or Circle the Wagons’?

By Leigh Page for Becker’s Hospital Review

As hospitals and large multispecialty group practices gear up for accountable care organizations, procedure-oriented specialists are still trying to figure out their role in them.

“Specialists are not taking the lead in the formation of ACOs,” says Aric Sharp, CEO of the Quincy (Ill.) Medical Group, a 130-provider multi-specialty group. “The physicians who are interested are in multi-specialty groups or integrated models with hospitals.”

This makes sense. Most specialists are focused on a particular episode of care, which is not what the ACO is all about. These new models of care emphasize the whole spectrum of healthcare, not just one episode.

ACOs need specialistsEverybody agrees, however, that ACOs will need to reach out to specialists and include them in their networks. Furthermore, even hospitals with many employed specialists may have to add independent specialists to fill out their networks, says Laura P. Jacobs, executive vice president of the Camden Group in Los Angeles. “Primary care physicians in ACOs will need specialists to link up with them,” she says. “They will want them to collaborate.”

But as ACOs begin to reach out to specialists, will specialists respond in kind?

Some observers believe some specialists will be swept up in the general enthusiasm for accountable care and find their place in ACOs. Paul Keckley, director of the Deloitte Center for Health Solutions, says specialists will join ACOs because “it’s better to be in the room. The natural inclination of most specialists would be it’s better to be a player than to be left out.”

The financial incentivesBut what specific incentives does a specialist have to join an ACO? Mr. Keckley and other ACO experts readily admit it could take years for many ACOs to make enough shared savings to pay out significant sums of money. Indeed, these sums would have to be hefty enough to be an incentive for the wary specialist to join up.

One impediment to initially paying out shared savings might….. (read complete article here).