About Half of Hospital Executives Plan to Implement Accountable Care Organization

Growing numbers of hospital executives plan to implement accountable care organizations (ACO) in 2014, according to one study, but a second study revealed that nearly half of the executives remain skeptical of their benefits.

ACOs are, according to the federal Center for Medicare and Medicaid Services, “groups of doctors, hospitals and other health care providers, who come together voluntarily to give coordinated high quality care to the Medicare patients they serve. Coordinated care helps ensure that patients, especially the chronically ill, get the right care at the right time, with the goal of avoiding unnecessary duplication of services and preventing medical errors.”

Healthcare performance improvement alliance Premier, Inc.’s fall 2013 Economic Outlook C-suite survey project hospital participation in ACOs to double in 2014

In the survey, more than 18 percent of the 115 senior executive respondents said their hospitals participate in an ACO, up from 4.8 percent in spring 2012.

About 50 percent of the survey participants expect their hospitals to participate in an ACO by 2014’s end. Overall, 76.5 percent say their hospital ultimately will participate in an ACO.

The most likely ACO participants are non-rural hospitals, followed by those in integrated delivery networks (IDNs), according to the survey.  While there’s minimal difference in ultimate participation, larger hospitals seem to make the transition to an ACO more quickly than their smaller counterparts.

However, ACOs still seem to have many skeptics.

Nonprofit healthcare consulting organization Purdue Healthcare Advisors conducted a survey that showed that 46 percent of hospital executives have no plans to implement an ACO any time soon.

“This survey has identified a significant need for advocacy and education to support hospitals and help them survive the wave of changes brought on by the Affordable Care Act,” said Mary Anne Sloan, director of Purdue Healthcare Advisors. “Hospital executives are charged with enhancing patient care and managing margins with a shrinking workforce and diminishing patient volumes.”

Some of the issues hospital executives raised include:

• Fears that ACOs are not stable and may pose a financial risk. About 52 percent of survey participants expressed concern over the unknown factors of ACOs. Some participants, about 49 percent, believe that their hospitals are not large enough to merit ACO.
• Worries that the unknown elements that may come from the Affordable Care Act (ACA) will add cost pressure concerned 89 percent of those surveyed. Fixing inefficiencies and cutting out waste is an overriding goal for 60 percent.
• Increased demand for support for Electronic Health Records (EHRs) complicates matters. About 56 percent of executives worry about the ability to work efficiently with other providers and 50 percent are concerned about analytics and retrieving data.  Being able to get staff ready and keep them trained concerned about 49 percent of survey participants and 37 percent worried about keeping patients engaged.