A recent survey conducted by Jackson Healthcare reveals that sixty-seven percent of physician respondents who participated in an ACO last year reported no personal financial benefit (in the form of a bonus, shared savings arrangement, etc.) as a result of their participation.
Why would anybody be surprised by this result?
As I have consistently pointed out, ACOs are about shifting control and financial rewards away from physicians, in favor of hospitals and payors, that is, chiefly the government as payor via Medicare.
Creating additional levels of bureaucracy – more paperwork, more direction, more top-down control – leaves less time for patient care, at least for care that is customized as opposed to cookie cutter. It leads to physician dissatisfaction and less, not more, job security.
Physicians participating in ACOs through hospital employment or affiliation via a captive medical group or foundation must develop networks to assist them in post ACO employment. Create options and alternatives.
Medical groups participating in ACOs through provider agreements while maintaining their independent practice need to avoid ceding too much control to the ACO and must structure their operation in a way that becomes less dependent upon the failure or success of the ACO.
Healthcare business and delivery models come and go. The secret is not to become so invested in their success that their failure causes yours.