I thought this blog post on the 3M blog made a good point about ACO’s finally having some action behind them thanks to the Pioneer ACO awards that were announced recently. Until now, we’ve basically just had people talking to each other about the idea of an ACO, how an ACO should take shape, etc etc etc. It’s nice to see us starting to move beyond discussion of ACO models and now starting to see some real people and companies that have to start taking some ACO action to see what they can create.
I have a feeling that much of this initial ACO work is going to be like most startup companies: failures. In the startup world, it’s just expected that at least 9 of 10 companies will fail. That’s part of the algorithm of innovation that has worked so well in the entrepreneurial environment we know as tech startup companies. I imagine we’ll see the same with a bunch of these ACO models in healthcare as well.
One major problem I do have with this comparison is that the ACO programs that we see now aren’t entrepreneur or market driven, but instead are driven by some sort of government money. This means that those that participate have a bunch of perverse incentives.
The blog post mentioned above provides some interesting suggestions on how to improve healthcare. In response I offered these thoughts in their comment section:
The suggestions you make are reasonable and interesting, but they seem to ignore the idea that what people are really going to do with ACO legislation is find the simplest way to extract the most amount of money out of the regulation. There will be some exceptions, but this is how it works with most government programs.
I imagine some will see this as a bit cynical. I personally just see it as realistic. If we want to talk about real solutions we have to talk about the stark realities that face us and not the idealized models that could happen “IF…” ACOs are no different. Enough with the IFs and let’s talk about action.