One of the most discussed provisions of the Affordable Care Act promising to "bend the cost curve" are Accountable Care Organizations (ACOs). CMS has now selected over 250, moreover physician-led, organizations as ACOs coverning four million Medicare beneficiaries. ACOs offer the promise of improved coordinated care, care quality and reduced Medicare costs. During this 27-minute interview Dr. Patel explains the impetus for and creation of Accountable Care Organizations, how rapidly ACOs are growing in number and what are some of the barriers limiting participation in the “shared savings” program. She explains further how Medicare reimburses ACOs (Type 1 and 2) and the concern among providers regarding the freedom Medicare beneficiaries have in seeking care outside their ACO. What ACO activity is occurring beyond Medicare or among large physician groups and private insurers, how and why ACOs might be successful and how and why ACOs serve as a catalyst for provider integration (and the downside risks involved with accelerated consolidation) are all also discussed. The interview concludes with a brief summary of the Brookings-Dartmouth ACO learning network (www.acolearningnetwork.org).
Dr. Kavita Patel is a Fellow in the Economic Studies program and Managing Director for clinical transformation and delivery at the Engelberg Center for Health Care Reform at the Brookings Institution. She is also a practicing primary care internist at Johns Hopkins Medicine. She served previously in the Obama Administration as Director of Policy for the Office of Intergovernmental Affairs and Public Engagement in the White House. Dr. Patel also served as Deputy Staff Director for the late Senator Edward Kennedy. She too has an extensive research and clinical background having worked as a researcher at the RAND Corporation and as a practicing physician in both California and Oregon. She earned her medical degree from the University of Texas and her masters in public health from the UCLA.