ACOs’ Coordinated Care Savings May Be Contagious

Accountable care organizations (ACOs) may actually be the unicorns we’ve been waiting for, spreading their cost-saving magic throughout the health system.

An early cost-sharing program in Massachusetts designed to cut costs for private Blue Cross Blue Shield patients also lowered costs for Medicare patients who were seen by the same providers, according to a study published Tuesday in the Journal of the American Medical Association.

An ACO is a network of doctors and hospitals that shares responsibility for providing care to a specific group of patients. The idea is to pay the providers for the quality of the services they provide, rather than the volume – in other words, to veer away from the fee-for-service system. The ACO is offered a bonus for giving patients high quality care at a reduced cost. But if they fail to hit certain quality targets or do not manage to reduce the cost of care, they will be paid less.

There are already more than 428 ACOs in the US, serving an estimated 14 percent of the population, including both Medicare and private-insurance patients.

But usually only a portion of patients in a health system are actually in the ACO—the rest of the patients served by a network remain in the regular old fee-for-service system.  Still, researchers at the Harvard Medical School say there appears to be a “spillover savings” for other patients in the health system.