An accountable care organization should cover no more than 20 percent of providers in its market, according to a new white paper released by the payors' trade group, America's Health Insurance Plans.
The white paper is based on an ACO forum hosted by AHIP in September, where presenters worried ACOs could end up having too much market power over payors, leading to higher prices rather than improved efficiencies.
The white paper suggested current minimum numbers of members under the healthcare reform law might force ACOs to go over that limit, the paper stated. The law's minimum of 5,000 Medicare beneficiaries might mean the ACO would have to include 30-50 percent of local providers in some specialties in its network.
Read the AHIP white paper on ACOs (pdf).
Read more coverage on ACOs:
- Are ACOs Promoting More Mergers and Acquisitions, FTC Asks
- Study: Performance Measurement and Evaluation Through EHRs Key to ACO Success
- 10 Recommendations on ACO Regulations From Premier's Collaborative
The white paper is based on an ACO forum hosted by AHIP in September, where presenters worried ACOs could end up having too much market power over payors, leading to higher prices rather than improved efficiencies.
The white paper suggested current minimum numbers of members under the healthcare reform law might force ACOs to go over that limit, the paper stated. The law's minimum of 5,000 Medicare beneficiaries might mean the ACO would have to include 30-50 percent of local providers in some specialties in its network.
Read the AHIP white paper on ACOs (pdf).
Read more coverage on ACOs:
- Are ACOs Promoting More Mergers and Acquisitions, FTC Asks
- Study: Performance Measurement and Evaluation Through EHRs Key to ACO Success
- 10 Recommendations on ACO Regulations From Premier's Collaborative