Why ACOs Are Like Unicorns And TV Sets

So I'm deeply grateful to the excellent reporters at Kaiser Health News for their clarifications — and particularly for their analogies. They've just put out a new guide on ACOs, including this:

ACOs have been compared to the elusive unicorn: everyone seems to know what it looks like, but no one has actually seen one. But the health care industry has already embarked on a frenzied quest to create them as quickly as possible. Today, after many delays and false starts, the Obama administration proposed guidelines on how ACOs will work.

Here is a brief guide to what we know about ACOs.

What is an accountable care organization?

An ACO is a network of doctors and hospitals that shares responsibility for providing care to patients. In the new law, an ACO would agree to manage all of the health care needs of a minimum of 5,000 Medicare beneficiaries for at least three years.

Think of it as buying a television, says Harold Miller, president and CEO of the Network for Regional Healthcare Improvement and executive director of the Center for Healthcare Quality & Payment Reform in Pittsburgh. A TV manufacturer like Sony may contract with many suppliers to build sets. Like Sony does for TVs, Miller says, an ACO would bring together the different component parts of care for the patient – primary care, specialists, hospitals, home health care, etc. – and ensure that all of the "parts work well together."

The problem today, Miller says, is that patients are getting each part of their health care separately. "People want to buy individual circuit boards, not a whole TV,” he says. “If we can show them that the TV works better, maybe they'll buy it," rather than assembling a patchwork of services themselves.

Now that, I get! And here's an extremely useful Kaiser Health News page with a whole bouquet of useful federal links on ACOs. Now we just need a Massachusetts equivalent — if anyone knows of one, please let us know.

For gluttons, there's also the four-minute video with Jordan Rau of Kaiser Health News discussing the ACO guidelines. And there's a delicious KHN/Washington Post piece today about how ACOs are creating a veritable gold rush for health care consultants.

This program aired on April 4, 2011. The audio for this program is not available.

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Carey Goldberg Editor, CommonHealth
Carey Goldberg is the editor of WBUR's CommonHealth section.



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