ACO Challenges Are Common to Value-Based Reimbursement

I just read a good article published in the Journal of the American Medical Association (JAMA), (August 17, 2011—Vol 306, No. 7) titled, "Implementing Accountable Care Organizations, Ten Potential Mistakes and How to Learn From Them" (subscription required). The piece focuses on the common mistakes health care providers may make in trying to develop accountable care organizations (ACOs). While the mistakes could also be true of value-based reimbursement, quality improvement efforts, capitation contracting, or total costs of care contracts, they are an excellent summary of the challenges facing ACOs. This article also reminds us that while we may have good models and tools for moving forward, the challenge will be in execution, in other words, assuring common knowledge and effectively using the available tools.

ACOs and other similar payment systems require significant rethinking how we deliver, measure, and monitor care. As we implement ACOs or other total costs of care payment systems, it will be critical that we are realistic about what we can achieve and the amount of work, education, and collaboration required to be successful.

Are these 10 mistakes the most prevalent and important, or are you seeing other challenges that this piece missed?