Growing an ACO — Easier Said Than Done

That’s the provocative title of the lead article in the September/October issue of Physician Executive Journal.  It describes how Baylor Health Care System in Dallas faces big hurdles creating an ACO, even though it has a 15 year head start building an integrated delivery system. But Baylor is committed: it’s made ACO development a strategic priority, is investing millions of dollars in disease and population management, and is visiting major employers to convince them to sign on to new integrated delivery products. Still, big question marks remain: Will Medicare pay enough? Will rules against fraud and abuse be interpreted to allow hospital-physician risk and gain sharing? Will doctors collaborate to the extent necessary? This well-done piece makes for good reading by doctors, directors and senior execs.

Bundled Payments: Primer for Boards

The October issue of Trustee magazine includes a concise primer on bundled payments and the implications that hospital and health system boards should understand. Bundled payments alter the incentives of fee-for-service. Instead of being paid more to do more, hospitals, physicians and other providers will be at risk for their costs , fixed prices and quality. The article explains how bundled payments may work and describes the major models and demonstration projects that are underway.

If you don’t subscribe to Trustee, you can see the article at the Trustee magazine website.