ACOs by state (Source: Leavitt Partners)
are the hot new health care trend, and there’s a out by Leavitt Partners trying to quantify just how hot they really are.
ACOs, as defined in the 2010 health law, are a delivery model that offers doctors and hospitals financial incentives to provide good quality care to Medicare beneficiaries while keeping costs down.
But that program hasn鈥檛 even launched yet, and already there are 164 鈥淎CO entities鈥 in the country, according to the Leavitt report. is a consultancy started by Michael Leavitt, a former governor of Utah and secretary of Health and Human Services under President George W. Bush.
To get their count of ACOs, Leavitt Partners examined news releases, media reports, trade groups and conducted interviews and considered a health system to be an ACO if it either self-identified as one or was 鈥渁dopting the tenets of accountable care.鈥 聽The report included systems working with private payers rather than Medicare.
Of the 164 鈥淎CO entities鈥 found, 99 were sponsored by hospital systems, 38 by physician groups and 27 by insurers. They were located in 41 states, though there were vast regional differences. Poor and rural regions were found to have little ACO growth.
In the Southeast and Appalachian regions, for example, which are among the least healthy areas of the country, there are few ACOs forming. That鈥檚 a shame, says Andrew Croshaw, managing director of health practice at Leavitt Partners, because 鈥渢hose are the regions of the country that would benefit most from coordinated care.鈥 Because those areas often have one dominant health system, Croshaw explains, 鈥渢here is less motivation to compete and there is more traction to remain with the fee-for-service system.鈥
The report also noted that much of the ACO growth seems to be in reaction to competition in the marketplace: 鈥淲hen one institution forms an ACO, its competitors often follow suit.鈥 In some regions, such as Boston, ACOs seem to be sprouting up like wildflowers, but in Washington DC, there isn鈥檛 much action.
While the term 鈥淎CO鈥 may be new, the report points out that the basic tenets of accountable care have existed for years. The study authors determined that their findings suggested a trend toward 鈥減roclaiming oneself as an ACO with only modest changes to the care process鈥 and not a total redesign.
They conclude that, at least for now, 鈥渄efining oneself as an ACO represents an acceptance of the direction the industry has been headed rather than an adoption of a truly new form of care delivery.鈥
Updated at 9:40 a.m. on Dec. 2 to correct an error in聽Michael Leavitt’s work history.
