Health plans have the proper access to capital, professional management experience, information technology infrastructure and experience with financial risk to lead the way in forming more accountable care organizations, according to an editorial published in the Journal of the American Medical Association.
In the article, the authors, Victor R. Fuchs, PhD, professor of economics at Stanford University, and Leonard D. Schaeffer, founding chairman of WellPoint and a professor at the University of Southern California, evaluate other potential players with the ability to create and manage ACOs — employers, physicians and hospitals — before settling on health insurers as the best option moving forward.
Hospitals have the capital and professional management, but not necessarily the background and mindset required to drive an ACO, the authors argue. Hospitals might also subvert the goal of competition among ACOs with more consolidations.
Employers would be able to bring costs under control but do not have the sustained interest or capacity to manage healthcare for employees, the authors say.
Physicians know the most about healthcare and can practice cost-effective medicine, but do no have the systems, administrative or financial functions to take a lead in forming a large number of ACOs, according to the authors.
The authors point to several health plan-led ACO efforts as examples of how ACOs could further develop in the future. They also argue regulators could accelerate ACO growth through modifying or removing federal and state laws, regulations and policies that may produce barriers of entry to ACO members.
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In the article, the authors, Victor R. Fuchs, PhD, professor of economics at Stanford University, and Leonard D. Schaeffer, founding chairman of WellPoint and a professor at the University of Southern California, evaluate other potential players with the ability to create and manage ACOs — employers, physicians and hospitals — before settling on health insurers as the best option moving forward.
Hospitals have the capital and professional management, but not necessarily the background and mindset required to drive an ACO, the authors argue. Hospitals might also subvert the goal of competition among ACOs with more consolidations.
Employers would be able to bring costs under control but do not have the sustained interest or capacity to manage healthcare for employees, the authors say.
Physicians know the most about healthcare and can practice cost-effective medicine, but do no have the systems, administrative or financial functions to take a lead in forming a large number of ACOs, according to the authors.
The authors point to several health plan-led ACO efforts as examples of how ACOs could further develop in the future. They also argue regulators could accelerate ACO growth through modifying or removing federal and state laws, regulations and policies that may produce barriers of entry to ACO members.
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