Accountable Care Organization (ACO) are new entities that will be created under the new health care law. The general idea is that a group of health care entities, which will include providers and hospitals will agree to participate in ACOs. The details on how this will save money and improve quality of care are still being worked out. One way or the other CMS will reward ACOs if they show that their activities result in overall savings and possibly better care.
How does this affect current options available to people in Oklahoma? First, we need to look at what options are available. The scope of this article does not allow for discussion of how current options in Oklahoma are different from those in other states. More on this in another post.
Multiple sources that describe ACOs point out that current health care delivery systems are fragmented. The basic assumption is that an integrated system results in better care. A spectrum is usually described that ranges from an individual independent physician’s office to a large health system. Let’s examine what is available in Oklahoma.
Individual providers: There are still a few providers left who practice solo or in the setting of a small physician’s group. Those are much more common in rural areas and there is only a handful of those left in the cities.
Large physician owned hospitals: Some examples come to mind when thinking about larger cities. Physician owned hospitals usually have a specialty expertise and care for patients with specific needs. One can think of a cardiac and orthopedic oriented entities, for example. There are some general hospitals that are owned and run by physicians in smaller towns.
Then, there are the large hospitals. Those are huge organizations that employ thousands of people and very commonly do business across state lines. Few of those are non-profit.
If ACOs become a reality, and most likely they will in one form or another, consolidation of small private places into larger systems may be expedited. Unless, a system is created where solo practitioners and small physician’s goups are able to integrate into large ACOs without loosing their individuality. Time will show if this is possible.
The ultimate answer will come from consumers. Do people from Oklahoma value their relationship with individual independent physicians? Or, is access to everything under the same roof is more important to them?
