Physicians gun-shy on ACOs over pay
Accountable care organization executives say doctors are skeptical about value-based payments and resistant to make the transition from fee for service.
A major stumbling block to the full implementation of accountable care organizations involves the challenge of moving the health care culture away from fee for service and toward payments based on the value of care, according to ACO executives speaking Feb. 13 at a National Committee for Quality Assurance webinar.
During the event, which featured some of the first ACOs to receive NCQA accreditation, some executives said physician compensation under their ACO models hasn’t changed but will soon. Some of the organizations became ACOs almost a decade ago, making them some of the earliest adopters of the business model that seeks to share savings through more coordinated care.
Some ACO executives said a major obstacle to internal alignment is the reluctance of some health professionals and payers to embrace the ACO model fully. It has resulted in a slower transition from fee for service to value-based payments, and, in some cases, the transition hasn’t even begun to take place.
“We are certainly not new to this, and despite the fact we have been involved with this on the Medicare side for a number of years, it really hasn’t had an impact on our marketplace,” said Douglas Carr, MD, medical director of education and system initiatives at the Billings Clinic in Montana, which became an ACO in 2005. “We are entirely fee for service. The managed care tidal wave never hit Montana at the end of the last century, so it never had an impact on the commercial market. It’s a very difficult environment to create an ACO discussion.”
via American Medical News | continue reading