Here is a
JAMA Viewpoint piece expressing a negative opinion about ACOs. (A
companion article in the same issue was favorable). Key points:
The authors point
out that any cost savings attributable to the ACOs appear to be
nominal. Moreover they tend to be offset by the bonuses paid out to
the participants. These bonuses cannot be considered optional
because they are inherent to the core notion of the ACO: that
“quality” will be rewarded.
The model creates
incentives to integrate services. Thus smaller hospitals close or
are merged, resulting in monopolies among health care delivery
systems. This reduces competition and tends to drive costs up, not
down.
No comments:
Post a Comment