Physician-led ACOs outnumber hospital counterparts

More accountable care organizations (ACOs) are now led by physicians than by hospitals, according to an analysis by the American College of Physicians.

The ACOs approved by the Centers for Medicare & Medicaid Services earlier this year pushed the number of physician-led groups to 202, compared to 189 for hospital-led groups, MedPage Today reported.

That marks a reversal from a year ago, when hospitals headed 91 ACOs compared to the 45 led by physicians, according to Neil Kirschner, Ph.D., the American College of Physicians' senior associate of regulatory and insurer affairs.

ACOs enable physicians to increase revenue by treating patients in their offices rather than hospitals, according to MedPage Today.

But hospitals face a "conundrum" in setting up ACOs, Kenneth Wilkins, M.D., president of Coastal Carolina Health Care in New Bern, N.C., said at the American College of Physicians annual meeting, MedPage Today noted.

"The way to save money in an ACO largely consists of decreasing hospital admissions and [emergency department] visits, which are hospital-based services," Wilkins said. "They get paid very well for these services. They stand to lose some revenue."

At the same time, physician-owned hospitals are earning significant quality-based bonuses under the Affordable Care Act, The Washington Post reported.

Physician-owned specialty hospitals are faring well under ACA programs to promote measurable quality and prevent excessive readmissions, the article noted, citing an analysis by Kaiser Health News.

Among the findings:

  • Of 161 eligible physician-owned hospitals, 122 are receiving bonuses.
  • Nine of the 10 hospitals receiving the largest bonuses are owned by doctors, with the average physician-owned hospital receiving 0.21 percent more for each Medicare patient during fiscal 2012.
  • About three out of four other hospitals are penalized under those same quality programs.

Kaiser Health News found that physician-owned hospitals admit relatively few heart failure and heart attack patients, key to the Medicare analysis, or low-income patients who might be more challenged in pursuing follow-up care necessary to prevent readmissions.

Many physician-owned hospitals also provide more patient luxuries and have lower patient-to-nurse ratios, raising their patient-satisfaction scores, according to the report.

To learn more:
- read the MedPage Today article
- here's the Washington Post / Kaiser Health News report