Physicians participating in Medicare accountable care organizations (ACOs) are only moderately convinced they do what was intended: deliver more cost-effective care.
A separate article in the publication also found substantial physician turnover and beneficiary ‘churn’ in one large Medicare Pioneer ACO that researchers studied.
In that ACO, operated by Boston-based Partners HealthCare System, researchers found the number of beneficiaries per physician was low (less than 5% of a doctor’s patients) and there was also substantial physician turnover. More than half of the physicians either joined (41%) or left (18%) the ACO during the 2012-14 contract period that was studied. When physicians left the ACO, most of their beneficiaries also left, the study found.
“These findings may help explain the muted financial impact ACOs have had overall, and they raise the possibility of future gaming on the part of ACOs to artificially control spending,” the authors wrote.
Despite physicians’ doubts about ACOs as an effective model, the doctors seem comfortable with their ability to adopt to the shift toward value-based payment and may not think the model is necessary to their success, researchers said.
ACOs were established under the Affordable Care Act (ACA), and while the future of the healthcare reform law is unclear, ACOs are expected to continue even if Republicans are successful in their efforts to repeal and replace the ACA.