Accountable Care Organizations are Coming, Medical Practices Must Be Prepared to Move Quickly, Concept Author Tells MedAxiom Conference

Cardiologists, other medical specialists face multiple options in implementing HCR provision; providing better care at lower cost seen as goal, with possible pitfalls

Oct 06, 2010, 15:00 ET from MedAxiom

SCOTTSDALE, Ariz., Oct. 6 /PRNewswire/ -- One of the authors of the emerging Accountable Care Organization (ACO) concept for health care says cardiologists may have to quickly assess whether to align themselves with ACOs, and if so, which ones.  But in a speech to cardiologists and practice leaders from around the United States, he cautioned that they must think through both clinical and business issues before pulling the trigger.

Steven Lieberman, formerly an assistant director of the White House Office of Management and Budget and Executive Associate Director of the Congressional Budget Office and currently a visiting Scholar at the Brookings Institution, told attendees at MedAxiom's Fall Conference this morning that while ACOs are a broad concept applicable to a wide array of settings, they will rapidly gain in importance under the health care reform legislation pushed by President Obama and passed by Congress earlier this year.

In remarks at the conference, Lieberman said that cardiologists may soon be faced with the choice of joining one or more ACOs, with potential varying outcomes.  While ACOs are designed to associate pools of patients with healthcare providers, allowing those providers to share in any cost savings, ACOs also make those providers accountable to simultaneously provide better care at less cost.  In assessing whether to participate in or form ACOs, "Given the technical requirements of how ACOs work, there are a number of variables to be considered," he said.  Examples of such considerations include "the stability of the patient pool, changes in the disease status of assigned beneficiaries, opportunities for lowering cost while improving quality, and whether cardiologists are acting more as primary care physicians (PCPs), coordinating overall care, or are seeing their patients on a more transactional basis as specialists."  

Lieberman also said that in many cases, cardiologists who have integrated their practices and are employed by larger healthcare organizations may have the ACO decision made for them by the larger group.  Integration is a key issue facing many practices today; a MedAxiom survey earlier this year revealed that more than half of all cardiology practices nationwide have already integrated with larger healthcare groups or are seriously considering doing so.

Lieberman has previously noted that ACOs require a minimum of 5,000 Medicare enrollees, but the recommended minimum number is 15,000 commercial patients.  ACOs have gained greater prominence at a time when the Federal government and many private health insurers are actively considering sharply lower reimbursement rates for services provided by cardiologists and other medical specialists.

Lieberman spoke at MedAxiom's Fall Conference, at which additional topics such as practice integration, payment reform, quality reporting and more are being actively discussed.  "Issues such as the growth of ACOs must be at the top of virtually every practice's agenda," said Patrick White, MedAxiom's president.  "Those that don't face the prospect of having the market decide for them, which nobody wants or can afford in today's rapidly changing healthcare environment."

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MedAxiom is a comprehensive subscription-based service provider, information and networking resource exclusively for cardiology practices encompassing academic cardiology organizations, hospital-owned cardiology practices as well as physician-owned cardiology groups. Based in Neptune Beach, Florida, MedAxiom supports over 300 cardiology practices across the United States, representing more than 5,400 cardiologists.  More information is available at