First National Survey Of ACOs Finds That Physicians Are Playing Strong Leadership And Ownership Roles

Abstract

The extent to which physicians lead, own, and govern accountable care organizations (ACOs) is unknown. However, physicians' involvement in ACOs will influence how clinicians and patients perceive the ACO model, how effective these organizations are at improving quality and costs, and how future ACOs will be organized. From October 2012 to May 2013 we fielded the National Survey of Accountable Care Organizations, the first such survey of public and private ACOs. We found that 51 percent of ACOs were physician-led, with another 33 percent jointly led by physicians and hospitals. In 78 percent of ACOs, physicians constituted a majority of the governing board, and physicians owned 40 percent of ACOs. The broad reach of physician leadership has important implications for the future evolution of ACOs. It seems likely that the challenge of fundamentally changing care delivery as the country moves away from fee-for-service payment will not be accomplished without strong, effective leadership from physicians.

Competencies Model of a Leader In a Healthcare Organization: International Experience of Distributed Leadership Implementation

“…В 2012-2013 гг. было проведено масштаб ное исследование ACO (Accountable Care Organizations 2 ), в ходе которого было уста новлено, что лидерство играет ключевую роль в реализации модели ACO [Colla et al, 2014]. Так, 51% таких организаций управляется врачами, врачи в большин стве в управляющих советах 78% такого рода медицинских заведений.…”

“…При этом ограничение финансирова ния затрат должно сопровождаться повы шением производительности труда меди цинских учреждений (см. : [Dorgan, Carter, Layton, 2011]). …”

Accountable Care Organizations: The First Two Years’ Performance and Directions for the Future

“…Proponents of the ACO model argue that providing a unified health care "home" can improve the quality and lower the cost of health care [3]. Advocates also assert that the role of physicians as leaders in ACOs gives the patient-physician relationship a more central role within the health care system [4].…”

“…Although conflict of interest precludes physician-completed assessments from factoring into shared savings, regular reflection and self-evaluation by physicians could improve the quality of care and physician well-being.The transition to an ACO also changes physicians' incomes, work environment, autonomy, and routine [4]. The level of upheaval associated with ACOs warrants examination of how physicians are responding to the transition and the changes that they see in quality of life for themselves and quality of care for their patients.…”

Beyond PCMHs and Accountable Care Organizations: Payment Reform That Encourages Customized Care

“…5 In 87 % of ACOs, at least one member of the ACO has experience as a PCMH and 56 % of ACOs with Question: How is a kilowatt-hour of electricity like a visit to a physician? Answer: Nobody wants either.…”