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Poll: Most healthcare organizations not optimistic on ACO participation

January 3, 2012
by by Healthcare Informatics
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Most senior executives at hospitals, health systems, and insurers are still undecided about their organization's participation in the Medicare Shared Savings Program (MSSP), commonly referred to as the Medicare ACO program, according to a poll conducted by the New York City-based audit, tax and advisory firm, which got an assist from the Washington D.C.-based healthcare legal firm Epstein Becker Green and the Addison, Texas consulting firm, JHD Group

The executives surveyed said their organizations do not have a comprehensive understanding of the various Centers for Medicare & Medicaid Services (CMS) programs and their financial implications, even after publication of final rules.

"Our survey findings indicate that healthcare leaders are still trying to get their hands around the opportunity and the risks associated with these programs," Ed Giniat, partner and sector leader for KPMG Healthcare and Pharmaceuticals, said in a statement. "Clearly, the priority for executives is to rapidly increase their knowledge about payment model reform and to accelerate their organizations movement toward new business models."

According to responses from healthcare leaders who participated in a webcast poll in November, 57 percent of hospital and health system respondents said they still don't know how the final rules will impact their organization's participation in the MSSP program. Sixteen percent, on the other hand, said their position was unchanged and they are still planning to participate, while  seven percent said the final rules have moved them to participate.  Thirteen percent, however, said their position not to participate remains unchanged.

Among health insurers, half of those polled said they still don't know about their organization's potential participation in the MSSP program.  Nineteen percent said the final rules had changed their position and they now plan to participate, and 10 percent said the final rules have had no impact on their decision and still plan to participate.  Only 2 percent said the final rules had no impact on their decision and they still don't plan to participate.

In fact, when asked about their organization's understanding of the various CMS programs and their financial implications, 36 percent of hospital and health system leaders said it was advanced or comprehensive, with 55 percent describing it as competent or decent, and 7 percent labeling it as weak.

Health insurers echoed a similar sentiment: 26 percent said their understanding was advanced or comprehensive, 62 percent said it was competent or decent, and 12 percent said it was weak.

Additionally, when asked how long it would take to achieve real results in coordinated care in the U.S., close to half of hospital and health system and insurer respondents said it would be 10 years, while 38 percent of respondents from hospitals and health systems and 43 percent of insurers said it would be 5 years.



Thank you for this article. As news of the ACO/MSSP rules and roll-out hit my inbox and news aggregator, I have been disappointed by the lack of awareness on the part of major healthcare players in my community. When I question the case managers at hospitals appointed to be "care transition coaches" about the possible effect of ACOs, they do not seem to be aware of Medicare's innovations. Numerous times, they have replied, "I have not heard of ACOs." Case managers will not be making the decisions about participation, but it seems as if their involvement will be key to the success of better coordination between providers. Your article highlights what I have been seeing: great news reporting on Medicare's innovations and slow uptake by providers.