Physician Alignment the Biggest Obstacle for ACOs

With such focus on health care it makes sense that attention is suddenly being paid to the concept of Affordable Care Organizations. ACOs are gaining popularity because they incentivize providers to work together to treat a patient across care settings. However, a survey by AMN Healthcare has revealed a rather large obstacle to the success of ACOs: physician alignment.

Of the 882 administrators and physicians surveyed a whopping 82% reported that physician alignment was the biggest obstacle to forming an ACO. That number comes from the 40% who cite is as the reason they are not moving toward an ACO and the 42% who already are moving toward an ACO.

The report stated that “aligning the interests of physicians and hospitals has historically been difficult.” The conflicts over patient care, costs and other issues will continue in the ACO model. In fact, switching to an ACO model might even make those issues more difficult because “it is unclear who will be at the helm of these organizations, how risk will be shared, and how reimbursement will be calculated.”

Since ACOs must be made up of primary care physicians, the report posited that staffing an ACO just might not be possible for hospitals and other facilities that are seeing a shortage of physicians.

The survey showed that the industry is split on whether or not to move toward ACOs, with 58% currently participating in ACOs, moving toward the model or contemplating moving to it, and 42% not expecting to move to the model.

Other hurdles listed by both those who are moving toward an ACO and those who aren’t were — in descending order of importance — lack of capital, lack of integrated IT systems and lack of evidence-based protocol data. Both groups listed these hurdles in the same order of importance.

“While capital and data are essential to forming ACOs, the success of this emerging model turns on people,” Susan Salka, chief executive officer at AMN Healthcare, said in a statement. “Health facility leaders and physicians must align their interests, communicate and cooperate for this model to work.

Next week will be the first of a two-part article on successful physician participation in ACOs.