Accountable care organizations: Early results and future challenges

Journal of Clinical Outcomes Management

Volumn 21, Issue 8, 2014, Pages 364-371

  Song, Zirui ^a  

^a MASSACHUSETTS GENERAL HOSPITAL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ACCOUNTABLE CARE ORGANIZATION; ARTICLE; BLUE CROSS BLUE SHIELD; CONTRACT; COST CONTROL; HEALTH CARE COST; HEALTH CARE ORGANIZATION; HEALTH CARE POLICY; HEALTH CARE QUALITY; HEALTH MAINTENANCE ORGANIZATION; HOSPITAL; HUMAN; MEDICAID; MEDICARE; PATIENT CARE; PHYSICIAN;

EID: 84911482667     PISSN: 10796533     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (62)

1. Orszag PR, Ellis P. The challenge of rising health care costs - a view from the Congressional Budget Office. N Engl J Med 2007;357:1793-5.
2. Chernew ME, Hirth RA, Cutler DM. Increased spending on health care: long- term implications for the nation. Health Aff (Millwood) 2009;28:1253-5.
3. Congressional Budget Office. Financing projected spending in the long run. Washington, DC: Congressional Budget Office; 2007 Jul 9.
4. Financing projected spending in the long run: letter from Peter R. Orszag, director, Congressional Budget Office, to Senator Judd Gregg, 9 Jul 2007.
5. Baicker K, Chernew ME. The economics of financing Medicare. N Engl J Med 2011;28;365:e7.
6. Chernew ME, Baicker K, Hsu J. The specter of financial armageddon - health care and federal debt in the United States. N Engl J Med 2010;362:1166-8.
7. Newhouse JP. Assessing health reform's impact on four key groups of Americans. Health Aff (Millwood). 2010;29:1714-24.
8. Emanuel E, Tanden N, Altman S, et al. A systemic approach to containing health care spending. N Engl J Med 2012;367:949-54.
9. Antos JR, Pauly MV, Wilensky GR. Bending the cost curve through market-based incentives. N Engl J Med 2012;367:954-8.
10. Centers for Medicare and Medicaid Services. More partnerships between doctors and hospitals strengthen coordinated care for Medicare beneficiaries. 2013 Dec 23.
11. Fisher ES, McClellan MB, Safran DG. Building the path to accountable care. N Engl J Med 2011;365:2445-7.
12. Muhlestein D. Accountable care growth in 2014: a look ahead. Health Affairs Blog. 2014 Jan 29. Available at http://healthaffairs.org/blog/2014/01/29/accountable-care-growth-in-2014-a-look-ahead/.
13. Fisher ES, Shortell SM. Accountable care organizations: accountable for what, to whom, and how. JAMA 2010;304:1715-6.
14. Fisher ES, Staiger DO, Bynum JP, Gottlieb DJ. Creating accountable care organizations: the extended hospital medical staff. Health Aff (Millwood) 2007;26:w44-w57.
15. Rittenhouse DR, Shortell SM. The patient-centered medical home: will it stand the test of health reform? JAMA 2009;301:2038-40.
16. Bodenheimer T, Grumbach K, Berenson RA. A lifeline for primary care. N Engl J Med 2009;360:2693-6.
17. Centers for Medicare and Medicaid Services. Improving quality of care for Medicare patients: accountable care organizations. 2011 Oct 20.
18. Centers for Medicare and Medicaid Services. Press release: Pioneer accountable care organizations succeed in improving care, lowering costs. 2013 Jul 16. Available at www.cms.gov/Newsroom/MediaReleaseDatabase/Press-Releases/2013-Press-Releases-Items/2013-07-16.html.
19. L&M Policy Research. Effect of Pioneer ACOs on Medicare spending in the first year. 2013 Nov 3. Available at http://innovation.cms.gov/Files/reports/PioneerACOEvalReport1.pdf.
20. Centers for Medicare and Medicaid Services. Performance year 1 interim results for ACOs that started in April and July 2012. 2014 Jan 30. Available at www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/Downloads/PY1-InterimResultsTable.pdf.
21. Wilensky GR. Lessons from the Physician Group Practice Demonstration - a sobering reflection. N Engl J Med 2011;365:1659-61.
22. Colla CH, Wennberg DE, Meara E, et al. Spending differences associated with the Medicare Physician Group Practice Demonstration. JAMA 2012;308:1015-23.
23. Berwick DM. Launching accountable care organizations - the proposed rule for the Medicare Shared Savings Program N Engl J Med 2011;364:e32.
24. Haywood TT, Kosel KC. The ACO model - a three-year financial loss? N Engl J Med 2011;364.
25. Iglehart JK. Assessing an ACO prototype - Medicare's Physician Group Practice Demonstration. N Engl J Med 2011;364:198-200.
26. Chernew ME, Mechanic RE, Landon BE, Safran DG. Privatepayer innovation in Massachusetts: the "Alternative Quality Contract." Health Aff (Millwood). 2011;30:51-61.
27. Song Z, Safran DG, Landon BE, et al. Health care spending and quality in year 1 of the alternative quality contract. N Engl J Med 2011;365:909-18.
28. Song Z, Safran DG, Landon BE, et al. The 'Alternative Quality Contract,' based on a global budget, lowered medical spending and improved quality. Health Aff (Millwood). 2012;31:1885-94.
29. Song Z, Fendrick AM, Safran DG, et al. Global budgets and technology-intensive medical services. Healthcare (Amst) 2013;1:15-21.
30. Salmon RB, Sanderson MI, Walters BA, et al. A collaborative accountable care model in three practices showed promising early results on costs and quality of care. Health Aff (Millwood). 2012;31:2379-87.
31. Markovich P. A global budget pilot project among provider partners and Blue Shield of California led to savings in first two years. Health Aff (Millwood) 2012;31:1969-76.
32. Terhune C. Anthem, HealthCare Partners save $4.7 million by coordinating care. Los Angeles Times. 2014 Jun 6. Available at www.latimes.com/business/money/la-fi-anthem-healthcare-partners-20140605-story.html.
33. Gbemudu JN, Larson BK, Van Citters AD, et al. HealthCare Partners: building on a foundation of global risk management to achieve accountable care. Commonwealth Fund Pub. 1572, Vol 2. 2012 Jan.
34. Rice TH. The impact of changing Medicare reimbursement rates on physician-induced demand. Med Care 1983;21:803-15.
35. Nguyen NX, Derrick FW. Physician behavioral response to a Medicare price reduction. Health Serv Res 1997;32:283-98.
36. Yip WC. Physician response to Medicare fee reductions:changes in the volume of coronary artery bypass graft (CABG) surgeries in the Medicare and private sectors. J Health Econ 1998;17:675-99.
37. Song Z, Ayanian JZ, Wallace J, et al. Unintended consequences of eliminating medicare payments for consultations. JAMA Intern Med 2013;173:15-21.
38. Marquis MS, Rogowski JA, Escarce JJ. The managed care backlash: did consumers vote with their feet? Inquiry 2004-2005 Winter;41:376-90.
39. Cooper PF, Simon KI, Vistnes J. A closer look at the managed care backlash. Med Care 2006 May;44(5 Suppl):I4-11.
40. Song Z. Pioneer accountable care organizations: lessons from year 1. In: Curfman G, Morrissey S, Morse G, Prokesch S, editors. Insight Center: leading health care innovation. N Engl J Med/Harv Bus Rev. 2013 Oct 8. Available at http://images.nejm.org/editorial/supplementary/2013/hbr06-song.pdf.
41. McWilliams JM, Landon BE, Chernew ME. Changes in health care spending and quality for Medicare beneficiaries associated with a commercial ACO contract. JAMA 2013;310:829-36.
42. Berenson RA. Shared savings program for accountable care organizations: a bridge to nowhere? Am J Manag Care 2010;16:721-6.
43. Meyer H. Accountable care organization prototypes: winners and losers? Health Aff (Millwood) 2011;30:1227-31.
44. Burns LR, Pauly MV. Accountable care organizations may have difficulty avoiding the failures of integrated delivery networks of the 1990s. Health Aff (Millwood) 2012;31:2407-16.
45. Song Z, Lee TH. The era of delivery system reform begins. JAMA 2013;309:35-6.
46. Colla CH, Lewis VA, Shortell SM, Fisher ES. First national survey of ACOs finds that physicians are playing strong leadership and ownership roles. Health Aff (Millwood) 2014;33:964-71.
47. Baicker K, Levy H. Coordination versus competition in health care reform. N Engl J Med 2013;369:789-91.
48. Baker LC, Bundorf MK, Kessler DP. Vertical integration: hospital ownership of physician practices is associated with higher prices and spending. Health Aff (Millwood). 2014;33:756-63.
49. Isaacs SL, Jellinek PS, Ray WL. The independent physician - going, going.... N Engl J Med 2009;360:655-7.
50. Kocher R, Sahni NR. Hospitals' race to employ physicians - the logic behind a money-losing proposition. N Engl J Med 2011;364:1790-3.
51. Gold J. Hospitals lure doctors away from private practice. Kaiser Health News, October 12, 2010.
52. Accenture. Clinical transformation: new business models for a new era in healthcare. 2012. Available at www.accenture.com/SiteCollectionDocuments/PDF/Accenture-Clinical-Transformation-New-Business-Models-for-a-New-Era-in-Healthcare.pdf.
53. Fraud and abuse: Leibenluft RF. ACOs and the enforcement of fraud, abuse, and antitrust laws. N Engl J Med 2011;364:99-101.
54. Kreindler SA, Larson BK, Wu FM, et al. Interpretations of integration in early accountable care organizations. Milbank Q 2012;90:457-83.
55. Cassel CK, Reuben DB. Specialization, subspecialization, and subsubspecialization in internal medicine. N Engl J Med 2011;364:1169-73.
56. West CP, Dupras DM. General medicine vs subspecialty career plans among internal medicine residents. JAMA 2012;308:2241-7.
57. Schwartz MD, Durning S, Linzer M, Hauer KE. Changes in medical students' views of internal medicine careers from 1990 to 2007. Arch Intern Med 2011;171:744-749.
58. Schwartz AL, Landon BE, Elshaug AG, et al. Measuring low-value care in Medicare. JAMA Intern Med 2014 May 12. [Epub ahead of print]
59. American Board of Internal Medicine Foundation. Choosing wisely: lists of five things physicians and patients should question. Accessed 26 May 2013 at www.choosingwisely.org/ doctor-patient-lists/.
60. Cassel CK, Guest JA. Choosing Wisely: helping physicians and patients make smart decisions about their care. JAMA 2012;307:1801-2.
61. Lewis VA, Colla CH, Carluzzo KL, et al. Accountable care organizations in the United States: market and demographic factors associated with formation. Health Serv Res 2013;48(6 Pt 1):1840-58.
62. Conrad D, Grembowski D, Gibbons C, et al. A report on eight early-stage state and regional projects testing valuebased payment. Health Aff (Millwood) 2013;32:998-1006.