By Gregg A. Masters, MPH

Can you feel it? Amidst the continued uncertainty spawned by the very principals who most directly hope to benefit from the continued diversion if not outright ‘anti ACA’ (i.e., Affordable Care Act) propaganda are data suggesting a possible shift in not only attitude but commitment to ‘accountable care’ and the structured entities codified in Federal regulation aka ‘ACOs’, to enable the transformation.

I am reminded of the Ghandi attributed and often quoted glidepath to innovation (if not revolution):

First they ignore you, then they ridicule you, then they fight you, then you win.”
— Mahatma Gandhi

One could make the argument that beginning with the Notice of Proposed Rule Making (NPRM) and the 1,300 plus comments it generated to the final rule release including the Pioneer, et al program sequelae, that we’re witnessing indicia of a paradigm shift towards a nascent ACO movement.

At the Wireless Life-Sciences Alliance meeting in May, one of Aetna’s senior executives disclosed a ‘backlog’ of 180 requests to work with the provider community in some ACO context or configuration.

So while the hollow theater continues in Washington D.C. and inside the conservative talk machine via it’s derivative ‘mindless echolalia’, we see tangible commitment to be part of the solution to the healthcare conundrum as more and more providers ‘get ACO religion’ and move away from the hand wringing towards the ‘triple aim’, or in the words of George Bernard Shaw:

This is the true joy in life, the being used for a purpose recognized by yourself as a mighty one; the being thoroughly worn out before you are thrown on the scrap heap; the being a force of Nature instead of a feverish selfish little clod of ailments and grievances complaining that the world will not devote itself to making you happy.
― George Bernard Shaw

So today we learned courtesy of CMS, via Modern Healthcare:

CMS announces 89 new ACOs

As of July 1, 89 new Medicare accountable care organizations started to serve Medicare beneficiaries in 40 states and Washington, D.C., the CMS announced Monday.

These new programs bring the total list of ACOs to 154, which includes 32 ACOs in the Pioneer ACO model from the CMS Innovation Center that were announced last December and six physician group practice transition demonstration organizations that began in January 2011.

“The Medicare ACO program opened for business in January, and already, more than 2.4 million beneficiaries are receiving care from providers participating in these important initiatives,” acting CMS Administrator Marilyn Tavenner said in a statement (PDF).

For the complete list of ACOs see: ACOs: The 2012 Line-Up.