Healthcare Business News

Clear path ahead

By Melanie Evans
Posted: November 10, 2012 - 12:01 am ET

President Barack Obama's re-election means hospitals and doctors can move with more certainty to develop accountable care, one payment model to be tested in the Patient Protection and Affordable Care Act, healthcare executives said.

For the nearly 150 accountable care organizations operating under two Medicare ACO programs rooted in the law, Obama's victory to the White House reduces the chance the federal programs will be dismantled, said Dr. Kevin Tabb, president and CEO of Beth Israel Deaconess Medical Center in Boston, which in January launched one of the first Medicare ACOs under the Center for Medicare and Medicaid Innovation's Pioneer model. The CMMI was created by the reform law.

More must be determined on the adoption of the law and development of accountable care, said Dr. Robert Margolis, CEO of HealthCare Partners, a division of DaVita HealthCare Partners, but “at least I don't think there's any dramatic change that we expect from the trajectory we're on.” The company also operates three of the first Medicare ACOs.

The stability brought by the election may prompt more organizations to proceed with ACOs, said Dr. Lawrence Casalino, the Livingston Farrand associate professor of public health and chief of the division of outcomes and effectiveness research at Weill Cornell Medical College. Hospital and medical group leaders may have hesitated to invest if they believed “things might come to a screeching halt in a year or two,” he said. “Now at least we have four more.”

Hospitals and medical groups could see additional incentives to adopt accountable care with an influx of newly insured patients and continued federal pressure to curb costs, said Stephen Shortell, a public health professor at the University of California-Berkeley Haas School of Business.

Officials with ACOs already under way also said the industry's push to overhaul delivery and payment did not depend on the election.

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Dartmouth-Hitchcock, also among the first Medicare ACOs, has entered into commercial accountable care contracts that would have continued regardless of who won the White House, said Lynn Guillette, director of its Payor Contracting and ACO relationships. And the time it would have taken a Republican administration to scrap the Affordable Care Act would have allowed Medicare ACOs to complete an initial three-year test, she said.

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