Physicians Leading Majority of ACOs in Medicare Shared Savings Program

April 11, 2012

What’s most interesting about the announcement is not the number of ACOs that will be formed, but the type of ACOs that will be formed.

This week, CMS unveiled the 27 health systems it has chosen to participate in Medicare’s Shared Savings Program as accountable care organizations (ACOs).

But what’s most interesting about the announcement is not the number of ACOs that will be formed, but the type of ACOs that will be formed.

“There were some people who feared that the only entities that would participate would be hospital-dominated systems,” Jonathan Blum, director of the Center for Medicare at the CMS, said in a call with reporters, according to ModernHealthcare. “That has not happened.”

In fact, just over half of the health systems chosen to participate in the shared savings program - which will receive financial incentives if they manage to improve quality of patient care at reduced costs - are physician-led, according to CMS.

[For more information on ACOs from a physician-perspective, read "ACOs: A Guide for Physicians."]

Essentially, it appears that more and more physicians are embracing new models of care - and they are beginning to take the lead when it comes to adopting them.

Not only that, larger healthcare systems and hospitals appear to be looking for physicians to take on more leadership roles.

Why? As reimbursement shifts from volume of services to value of services, physicians will help determine a health system’s financial success or failure. That’s because physicians work closest with patients, they make the key treatment decisions, and as a result, they play a key role in quality and cost of care.

“To be successful, healthcare organizations can no longer afford to use the 'us' (practitioners) against 'them' (administrators) paradigm,” Christine Mackey-Ross, a senior vice president of the executive search firm Witt/Kieffer, wrote in a recent article appearing in The Atlantic. “They need a combined talent approach that puts the best minds on the field, advancing quality, safety, and cost goals together.”

She notes that there has already been a “major uptick” in the number of physicians who are taking on new leadership roles major healthcare systems, such as that of chief quality officer and chief clinical integration officer.

In fact, according to Witt/Kieffer, 64 physician CEOs are already leading healthcare systems across the country, and many more physician executives are in the talent pipeline.

Also in the pipeline? Many more physician-led ACOs. CMS is reviewing another 150 applications from additional ACOs seeking to enter the program in July.

For now, the 27 ACOs just announced will serve an estimated 375,000 beneficiaries in 18 states, according to CMS.

Florida and New York will each boast five ACOs; North Carolina and New Jersey, three; California, Texas, and Massachusetts, two; and Arizona, Kentucky, Georgia, Wisconsin, and New Hampshire, one.

What do you think? Will new models of care like ACOs and new reimbursement trends result in more physician leadership roles? If so, how do you think that will influence the healthcare delivery system?