This report from the Institute for Health Care Reform explores the challenges that providers face when creating accountable care organizations (ACO). The report notes that providers will find it difficult to adopt new quality standards while still providing adequate care to current patients. Additionally, the authors suggest that payers should be prepared to assist providers in making initial investments that may be necessary to make ACOs effective like health information technology.

From the report:

Policy makers hope that the development of accountable care organizations (ACOs)— organized groups of physicians, hospitals or other providers jointly accountable for caring for a defined patient population—can improve health care quality and efficiency. An examination of existing provider efforts to improve care delivery illustrates that substantial financial and time investments are required to accomplish changes in care delivery, even among groups of providers affiliated with one another for many years, according to a new qualitative research study from the Center for Studying Health System Change (HSC). A common challenge for health care organizations’ efforts to improve care—similar to what the ACO concept seeks to encourage—is implementing changes with minimal disruption to patients and productivity. To achieve improvements in care delivery, the seven provider organizations studied tapped existing financial reserves or external grant funding. They also sought strong physician and organizational leadership and encouraged transparency and flexibility when making changes. As payers develop guidelines to contract with ACOs, they will need to support providers’ capability to develop and sustain improvements in care delivery, such as new health information technology and data reporting systems.

Full Report: Lessons from the Field: Making Accountable Care Organizations Real (PDF | 240 KB)

Institute for Health Care Reform. (2011). Lessons from the field: making accountable care organizations real. Lake, T., Stewart, S., and Ginsburg, P.