After CMS announced 106 new Medicare accountable care organizations in January, only 35 new commercial ACOs have been announced, according to a Health Affairs blog written by David Muhlestein from Leavitt Partners.
This represents a slowdown in ACO growth after the model exploded from a few dozen ACOs at the end of 2010 to roughly 500 after September 2013.
Mr. Muhlestein called the slowdown "surprising," but offered the following three reasons as to why fewer ACOs have formed this year.
1. Lack of trailblazers. Most of the "trailblazing" hospitals, health systems and physician groups — those ready and willing to pursue risk-based accountable care contracts — have already done so.
2. No clear successful model to follow. Organizations that are interested in accountable care, but not yet ready to make the leap into risk-bearing contracts, are waiting on a clear ACO model to emulate, according to the post. As no such silver bullet exists for ACOs, these organizations are reluctant to move forward.
3. Reluctant payers. Though some payers have enthusiastically pursued accountable care contracts with provider organizations, many others are still holding back, further slowing the growth of the model, according to Mr. Muhlestein.
Mr. Muhlestein wrote he believes organizations that fall into the second category, that are waiting, will look to how many current ACOs renew contracts with the payers before jumping into the model. "Going forward, this rate of renewal will be a strong indicator of whether potential ACOs will become actual ACOs," he concludes.
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