New payment models adopted by Medicare and many health plans have clearly led to better care for patients. They also might be helping to slow the overall growth of healthcare spending. Whether these gains can be sustained, however, is far from certain. And because many providers are still sitting on the sidelines, uncertainty is a serious threat to progress.
The recent announcement by HHS Secretary Sylvia Mathews Burwell that Medicare will work to accelerate the transition to new payment models was therefore an important step in the right direction. But without significant regulatory—and perhaps legislative—changes to current models, HHS' ambitious goals are not likely to be achieved.
Accountable care organizations—groups of providers held responsible for the quality and cost of care delivered to their patients—are critical to payment reform. For ACOs to work, though, it is clear that we need to make two key reforms: improve the financial model for ACOs and make it easier for them to engage their patients in their own care and in making wise decisions (often referred to in shorthand as “patient engagement”).