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All Things HIT

Sep 16 2011   10:14AM GMT

AAFP discussion on ACO’s, has questions, fears, but opportunity.



Posted by: AllinHIT
AAFP, Accountable Care Organizations, ACO's, American Academy of Family Physicians, Physician adoption

Yesterday, while attending the AAFP Scientific Asssembly in Orlando, I haphazardly, and happily, assisted in leading a table top discussion on Accountable Care Organizations (ACOs). After probing and discussing this topic with physicians, I recognized their need for understanding the opportunity for primary physicians, the two versions of the Shared Savings Program, and most of all, an increase in their participation for the regulation and structure of ACOs.

I attended the session in order to learn and gauge physicians’ levels of understanding pertaining to ACOs, and contribute to their knowledge of the subject.  What first surprised me was the “baker’s dozen” that attended.  I expected more of a turn-out, as did others, because of the role this model presents for the primary family physician (your PCPs).  The second surprise was that the discussion lacked a formal AAFP moderator! Again, considering the impact of this model, I expected more focus and resources dedicated to the subject. These surprises led me to believe, there should be a greater effort toward educating physicians on the impact that ACOs can have on revenue, and in some cases, losses (three year threshold rule in the Medicare ACO Shared Savings model). Education will then translate to greater participation, not only in ACO discussions, but in lobbying efforts of various organizations, like the AAFP, AMA, and the NMA. 

It was well noted by myself and a mixture of physicians, like Rishi N Sud with the Union Medical Center, that opportunities exist for physicians to form ACOs.  Union Medical, based in Chicago, is a staff model HMO with a functioning, effective PCHM, well poised in creating an ACO.  This, and an IPA structure, presents opportunities for physicians to collaboratively provide quality care while increasing their revenue with Shared Savings. With an ever-changing and debated Medicare SGR, this could be a welcome offset! 

Of course, there were many questions concerning ACOs various structures, needs, and challenges, as well.  It was suggested that ACO’s boards of directors include the voice of the primary physician. And the mere definition of an ACO was questioned, as well, where we all gave our general, layman’s terms definitions.  As a health IT guy, I discussed the necessary role of EHRs, telehealth, and sharing PHI (protected health information). I also noted technology’s role with the various Beacon Communities, using it for coordination of care, disease management, and remote services (telehealth).  Hospitals dominanting the space and payors’ ACO pilots and activities were other concerns expressed. 

Despite the challenges and questions, however, the opportunity to coordinate all aspects of care in the ACO model excited the group the most.  It was almost as if the primary physician will have a reprieve of importance, equal to specialists, in delivering patient care.  I hope they’re right!

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