Dr. Donald Berwick Defends ACOs in Expert Roundtable

Donald Berwick, MD, recently said the "edgy and promising design" of accountable care organizations will work because of the focus on transparency, coordination, consumer power and intolerance of waste, according to a Wall Street Journal report.

Dr. Berwick was one of three experts who participated in a roundtable ACO conversation published by the WSJ. Although he stepped down from his position as CMS administrator Dec. 2, he still thinks applications for the ACO program will exceed expectations, particularly since the Pioneer ACO Program received a significant amount of interest from providers.

Jeff Goldsmith, president of consulting firm Health Futures and associate professor of public health sciences at University of Virginia, did not express an equally optimistic view. He said the model isn't likely to save any money and "looks like a terrible business deal for providers" due to high upfront costs to possibly get 50 or 60 cents back in 18 months. "Looks more like Tom Sawyer's fence-painting project to me," Mr. Goldsmith said in the report.

Dr. Berwick responded to Mr. Goldsmith's comments, saying providers will need to make upfront investments "but returns should mount as capabilities grow; that is, after all, what investment means," according to the report. Dr. Berwick also said he doesn't agree about the magnitude of the start-up costs and "nor apparently, do the dozens of applicants for the pioneer program, who must find these costs acceptable or they wouldn't play," according to the report.

Related Articles on ACOs:

6 Health Systems Are First to Apply for ACO Accreditation From NCQA
NEJM: ACOs Won't Carry "Out of Shape" Hospitals to Success
Survey: 57% of Hospital Leaders Still Unsure About ACO Participation


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