Health & Wellness

Specialists In ACOs

Seems like everywhere you turn in healthcare these days, people are talking about Accountable Care Organizations. The buzz surrounding ACOs continues to grow, as trends in healthcare advance from volume to value.

“I’m a specialist – where do I fit in?”

ACOs are groups of providers who agree to work together to provide higher quality and more coordinated care. While it is true that primary care providers play a key role in value-based healthcare models, many experts believe that Accountable Care Organizations cannot be successful without bringing specialists into the mix. Integrating specialists into ACOs means that these physicians will also be held accountable for the cost and quality of care they provide. Doesn’t it make sense that all members of this medical community would be held to the same high standards and also have the same opportunity for quality-based rewards?

Stronger and yet more flexible partnerships between primary care physicians and specialists are needed for ACOs to be effective at driving better outcomes and managing risk. A recent blog called “A Role for Specialists in Resuscitating Accountable Care Organizations” in Harvard Business Review emphasizes that “specialists are every bit as important to the health of a patient population as their primary care counterparts.” As ACOs continue to evolve, these models will focus on the delivery of healthcare as a provider-team effort rather than an insurance initiative or referral generator. Down the road, healthcare spending will be disease-based rather than broken down by provider. In other words, costs will be shared by primary care physicians and specialists who are co-managing patients and populations within a given disease. In this scenario, a diabetic patient’s primary care provider and endocrinologist will have an equal stake in keeping him healthy.

In an increasingly ACO-dominated world, it is vital for specialists to work closely with primary care physicians to show that they are helping improve quality and efficiency. The American Association of Orthopaedic Surgeons explained the importance of specialist participation in the development and management of ACOs. Specialists, they say, “play a vital role in ensuring the appropriate access to and use of specialty services by patients and their primary care providers.” As this industry-wide shift towards maximizing value continues, specialists who don’t adapt and join ACOs will find themselves missing out on revenue and falling behind the curve. Most importantly, the collaboration between all providers of healthcare will play a key role in improving the nation’s overall health.

To learn more about the Privia Quality Network, an accountable care organization made up of over 180 elite physicians in the Washington DC area, please email physicians@priviahealth.com

Articles Referenced:

Harvard Business Review:

http://blogs.hbr.org/2013/11/specialists-can-help-resuscitate-accountable-care-organizations/

American Academy of Orthopaedic Surgeons:

http://www.aaos.org/news/aaosnow/jul11/advocacy1.asp

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