As 2014 draws to a close, we are finally beginning to see the results of some of the first, most basic types of studies that attempt to describe, characterize, or assess the progress of ACOs. Shortell, McClellan, Ramsay, Casalino, Ryan, and Copeland published such an article in the October 2014 issue of Health Services Research entitled “Physician Practice Participation in Accountable Care Organizations: The Emergence of the Unicorn.” They found that, to date, no studies had been published looking at the rate of individual physician practices joining or planning to join ACOs. Using data from the National Survey of Physician Organizations III (collected in 2012-2013), they were able to look at 1,183 practices that were in one of three groups: already in an ACO, planning to join an ACO within a year, or those that had no cur-rent plans to join an ACO. About a quarter of the practices were already participating in an ACO, with another 16% planning to join an ACO within a year. Nearly 75% of practices participating in ACOs had 100 or more physicians, even though nearly half of practices in the US are comprised of 5 or fewer physicians. Practices in New England and the East South Central region of the United States were also more likely to join ACOs, as well as practices that receive patients from an IPA or PHO. The study found no statistically significant differences in ACO participation based on ownership structure or specialty mix. The authors stress that it is typical for large, well-networked practices to be the earlier adopters of the ACO model, but there is a growing need for longitudinal studies that are able to assess how early adopters are achieving the ACO “triple aim” of better quality, better health, and lower costs.
Published: January 26, 2015