An analysis of four Medicare accountable care organizations (ACOs) has found that surgeons are largely absent from the executive committees of these organizations. The analysis, published in the journal Health Affairs, included a survey of early Medicare ACOs that were operating in 2012 as well as case studies of four of these organizations. Of the 28 respondents who participated in the survey, half said that no surgeons were members of their executive committees. The case studies also showed that surgeons were not among the executive committee members at two of the four Medicare ACOs. In addition, the analysis found that none of the top strategic priorities at any of the ACOs included surgical care. Researchers offered a variety of reasons for why surgeons are largely absent from ACO executive committees, including the fact that none of the Centers for Medicare and Medicaid Services’ ACO quality measures directly address surgery or surgical care. The analysis also noted that surgeons are largely choosing not to join ACOs because ACO incentives are not strong enough to prompt them to change their behavior on quality or cost targets. Finally, the analysis found that 88 percent of the ACOs that were surveyed were unaware of the role and cost of surgical care in total spending. Failing to take into account the role and cost of surgical care, the analysis found, may result in the loss of any savings that ACOs achieve by meeting their chronic disease management goals given the significant role surgical care plays in both hospital expenses and total healthcare spending.
From the article of the same title
Modern Healthcare (06/02/14) Evans, Melanie
via This Week @ ACFAS.