ACO Is Not One Size Fits All

August 6, 2014
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Preparing for an Accountable Care Organization conversionA common misconception about ACO conversion is that there is a single method of planning and implementation that will work for all healthcare organizations.

Preparing for an Accountable Care Organization conversionA common misconception about ACO conversion is that there is a single method of planning and implementation that will work for all healthcare organizations. To dispel this belief is first and foremost in understanding the reality of ACO conversion for your organization.

As with most decisions related to healthcare, your organization wants to be sure that it is acting in line with your previously stated mission and values. It is through these two brief, but important, written declarations that you communicate with patients and earn their confidence. When you are considering ACO conversion, you should be sure that you are acting not only in the interest of the organization, but the population that you serve. In order to determine whether or not you are prepared for ACO conversion, you should weigh the pros and cons, not only for your staff, but for your patients as well.

Pros and Cons of ACO Conversion: Organization

At the organizational level, many of the immediate benefits of ACO conversion come in monetary form. This isn’t inherently negative; hospitals need to be concerned with their finances and they should, particularly in this day and age, be focused on providing quality care without wasting money – the hospital’s or the patient’s.

Of course, that being said, there is a con regarding this as well: the start-up cost of such a conversion can be incredibly costly; hence, why the decision to convert is not one to be taken lightly. Of course, over time, the increased sustainability of the organization and the loyalty of their patients will earn them back that start-up cost and they will continue to profit. So, like many things in life, up-front investment may hurt a little, but over time it will support the health of the organization.

Similarly, we know that start-up costs for Electronic Health Records can be terrifying, but we’ve also seen that hospitals are continuing to reap the benefits of their implementation – even just a few years out from go-live.

For hospitals and physician groups, the appeal of shared risk and shared responsibility that comes with ACO status is a factor that weighs heavily on the prospect of physician buy-in. While there are some who see this as a pro, it could also be perceived as a con; particularly by specialist groups who prize their autonomy. The only consolation for these groups would be, I suppose, the potential for new patients – but for many, this is not quite enough to sway them in the direction of ACOs.

Pros and Cons of ACO Conversion: Patients 

For patients, though they may not realize it, ACOs will directly influence the way they receive healthcare. Their care is almost guaranteed to be more comprehensive, better coordinated and they will have the novel opportunity to become somewhat of an equal-player in the management of their chronic conditions.

Of course, with all of this coordination comes an increased risk of privacy violations. More people than ever now have easy access to patient records. While they are all, supposedly, members of a patient’s care team, there is always the potential for even internal players in an organization to have ulterior motives when viewing patient records- even if it is something as seemingly innocuous as curiosity. With the advent of Electronic Health Records that are accessible from many doctor’s offices, perhaps even states away, the temptation to “checkup” on extended family and friends, even neighbors or coworkers, is real and it is something that will need to be confronted head on by organizations in order to keep patient’s faith in their privacy.

For patients too, not just their healthcare providers, the prospect of major change is difficult. We all have one patient or colleague who has said something along the lines of, “This isn’t how we do things.” Change is difficult – no one is likely to argue with you about that! But the entire motivation behind ACOs is that together we can support one another, and our patients, and create a more well-oiled healthcare machine. Yes, this is not how we do things – but many who have worked in healthcare over the course of the last several decades won’t hesitate to lament at how inefficient and, at times, even unsafe, current methodologies are- not just for patients but providers as well.

The point is, ACO conversion is not a solitary endeavor. If you’re considering it, in the midst of it, or well on the other side – know that you are not alone in your hard work and that the landscape of healthcare will soon be rising up to meet you.