Are ACOs the New HMOs?

June 15, 2014
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ACOs: The New HMOs? 

Historically, HMOs are notorious for incurring poor health among patients and bolstering already bloated administrative costs. When healthcare reform was on the horizon, the promise of Accountable Care Organizations in lieu of traditional HMOs lifted the wilted spirits of doctors and patients alike. A few years of ACOs, however, seems to have done little to assuage the initial fears of these groups that ACOs are just nicely dressed HMOs.

ACOs: The New HMOs? 

Historically, HMOs are notorious for incurring poor health among patients and bolstering already bloated administrative costs. When healthcare reform was on the horizon, the promise of Accountable Care Organizations in lieu of traditional HMOs lifted the wilted spirits of doctors and patients alike. A few years of ACOs, however, seems to have done little to assuage the initial fears of these groups that ACOs are just nicely dressed HMOs.

ACOs and HMOs

Too Cost-Concerned? 

A major concern has been that both HMOs and ACOs focus too much on how physicians will be paid and not enough on how patients will get the care they need. It seems counterintuitive that patient care would take a back seat to anything, but the theory at present is that by increasing provider incentives and reforming the payment systems, patients will ultimately be better served.

Change Is Never Easy. 

That being said, change is never easy. Not for the physicians and payers, and certainly not for patients. By enacting and committing to a sense of transparency with all the changes on the healthcare horizon, the hope is that patients will acquire some faith and trust in the healthcare system: a trust that needs be restored after at least a decade of obstructed views.

Are ACOs More Concerned With Patients? 

On the surface, it appears that many of the incentives that existed in HMOs have manifested themselves in the ACO blueprint. Digging a little deeper, however, the ACO seems to have developed a much broader consciousness around the evolving needs of patient populations. While it’s true that sicker, chronically ill patients will always drive up premiums, instead of focusing on solely finding and paying for the healthiest patients, action is in place to improve population health overall. This way, more patients are healthy, or their chronic conditions managed, than not. This benefits everyone: physicians, payers and patients.

Everyone Is Talking About ACOs.

While this is still a theory more than a practice, the idea has permeated public awareness and discussions are cropping up more and more readily. Taking to social media, hashtags of #ACO #MCO and #Healthcare have become proliferated and now, more than ever, the great healthcare debate is not just water-cooler conversation, but now one that families have around the dinner table as well. With patients taking on more and more responsibility for their care and demanding more transparency from payers and physicians, the time for change has arrived.

Patients are, contrary to popular belief, ready to see change. The question is, can the payers and physicians deliver real change, or will ACOs just be a dolled-up version of the same old HMO?

What are your thoughts? Do you think ACOs are just another HMO? 

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