ACOs could upset payer market

Number of ACOs could triple this year
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Medicare accountable care organizations (ACO) could triple this year, according to Richard Weil, a healthcare consultant at Oliver Wyman, who found that one in 10 Americans is now treated by an ACO provider, WHYY's NewsWorks reported.

Five hundred organizations already have applied to become the third Medicare cohort, and 106 became official Medicare ACOs today, bringing the total to more than 250 since the Affordable Care Act passed.

Called the real "game changer" of the health reform law, ACOs are expected to significantly grow in the coming months, according to NewsWorks. ACOs would grow so much that former Obama adviser and University of Pennsylvania medical ethicist Zeke Emanuel said ACOs would make traditional insurance companies less relevant over a decade.

"I do think that many of them are going to begin to ask, especially if the exchanges expand, why are they contracting with the insurance companies as the middle men, they could just go into the exchange themselves," Emanuel said.

Nevertheless, providers and payers are teaming up in accountable care. Banner Health Network and Humana signed a deal targeted at Medicare Advantage members in Arizona, the former announced yesterday.

Meanwhile, BayCare Health System and Cigna launched the ACO, BayCare Physician Partners, aimed at Tampa, Fla., members, the latter announced Monday.

And Boston's Beth Israel Deaconess Medical Center (BIDMC) yesterday announced the new Beth Israel Deaconess Care Organization, an ACO with other community hospitals and physicians. BIDMC said the restructuring enables hospital ownership to jointly contract with payers in the future.

"We have worked to develop this new ACO structure, unique to Massachusetts, to directly respond to the needs of community hospitals and physicians. Working together, we are all focused, not only on transforming how high quality care is provided consistently and efficiently to patients and communities, but also on keeping people healthy and out of the hospital to begin with," BIDMC President and CEO Kevin Tabb said in the statement. "This is the way of the future."

For more information:
- read the NewsWorks article
- here's the Banner statement
- see the Cigna statement
- read the BIDMC statement

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