The accountable care organization (ACO) model has returned inconsistent results for providers trying to optimize their use of pharmaceuticals, according to responses to the National Survey of Accountable Care Organizations. Many (70%) providers reported being ready to electronically transmit prescriptions, while only 9% said they were well-prepared to notify a physician when a prescription has been filled.
ACO supporters note the pay-for-performance aspect and its potential for reducing costs compared to today’s commonly-used fee-for-service system as a reason to covert to the ACO model. But the national ACO survey failed to provide evidence of costs savings. Only 7% of the 46 respondents confirmed they are able to demonstrate the monetary value of appropriate medication use.
A lack of proof of cost benefits isn’t the only reason providers are hesitant to adopt the ACO model. A recent Workgroup for Electronic Data Interchange (WEDI) report gathered responses from 53 hospitals on why they are reluctant to adopt a new payment model. Beyond a lack of internal stakeholder interest, the providers named regulatory hurdles, a lack of bandwidth and technological infrastructure issues as ACO barriers.
Physicians, specifically independent doctors, aren’t optimistic about their professional futures in an ACO environment. In comparison to employed physicians, independents are 16% less likely to believe that ACOs will improve care, according to athenahealth Inc.’s Physician Sentiment Annual Survey. Independent doctors are skeptical of the potential financial benefits of ACOs and other new commercial and public payer reimbursement models. They are 61% more likely than employed physicians to think that ACOs will make it more complicated for them to get paid, and 43% more likely to believe new payment models will negatively affect their practices’ bottom line.
Including the recent HHS announcement of 123 news ACOs, more than 360 total ACOs have been established since the passage of the Affordable Care Act. Some 5.3 million Americans with Medicare are served by these ACOs, which are helping slow the increase in healthcare costs and providing patients with coordinated care according to the HHS release.