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Medicare: the place to start delivery system reform
1Kaiser Permanente Institute for Health Policy in Oakland, California, USA. jay.crosson@kp.org
Health Affairs (Project Hope)
|January 29, 2009
Summary
Accountable Care Organizations (ACOs) are key to healthcare reform. Medicare should lead payment design changes to enable successful ACO implementation and physician-hospital integration.
Area of Science:
- Healthcare delivery system reform
- Health economics
- Health policy
Background:
- Accountable Care Organizations (ACOs) represent a significant model for reforming healthcare delivery.
- The Medicare program has the potential to drive essential changes in healthcare.
- Successful physician-hospital integration is crucial for ACO development.
Purpose of the Study:
- To outline the importance of Accountable Care Organizations (ACOs) in delivery system reform.
- To emphasize the role of the Medicare program in initiating necessary transformations.
- To highlight critical considerations for successful ACO implementation.
Main Methods:
- Analysis of payment design and incentive structures.
- Review of delivery system reforms.
- Examination of legal, regulatory, and antitrust frameworks relevant to healthcare integration.
Main Results:
- Payment reforms are essential and should precede other changes.
- Reforms may require substantial, cumulative, and dramatic design modifications.
- Learning from existing physician-hospital integration models is necessary.
Conclusions:
- The Medicare program is pivotal for advancing ACO development.
- Significant and foundational payment reforms are critical for ACO success.
- Addressing legal and regulatory challenges is vital for realizing the potential of ACOs.
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