Not many hospitals were participating or planning to participate in an accountable care organization last year, but among those that were, physicians were front and center in governance of the ACO, according to a new issue brief from the Commonwealth Fund.
The Commonwealth Fund reported that only about 13% of hospitals surveyed were participating or planning to participate in an ACO; 12% were unsure; and 75% said they were not exploring the model at all.
However, the survey was conducted between May and September of 2011, and the CMS released its final rule on its Medicare shared-savings ACO in October 2011. This final rule was much more warmly received by the healthcare industry than the proposed rule issued in March of last year.
The brief also noted that, as of this summer, 154 groups were participating in CMS-sponsored ACO initiatives. A recent report, it added, identified 221 ACOs in 45 states.
In the Commonwealth Fund's survey, 3.2% of respondents were already participating in an ACO at the time, and 9.6% were planning to do so. Of this group, 51% said they were participating or planning to participate in a physician-hospital joint venture and 20% said the ACO would be physician-led, while 18% had hospital-led governance and 2% were payer-led.