Accountable Care Organizations May Have Difficulty Avoiding The Failures Of Integrated Delivery Networks Of The 1990s
- 1 November 2012
- journal article
- review article
- Published by Health Affairs (Project Hope) in Health Affairs
- Vol. 31 (11), 2407-2416
- https://doi.org/10.1377/hlthaff.2011.0675
Abstract
Accountable care organizations are intended to improve the quality and lower the cost of health care through several mechanisms, such as disease management programs, care coordination, and aligning financial incentives for hospitals and physicians. Providers employed several of these mechanisms in forming the integrated delivery networks of the 1990s. The networks failed, however, because of heavy financial losses stemming from hospitals' purchase of physician practices and their inability to align incentives, garner capitated contracts, and develop the infrastructure to manage risk. Although the current mechanisms underlying accountable care organizations continue to evolve, whether and how they will have an impact on quality and costs remains open to question. Care coordination and information technology are proving more complicated and expensive to implement than anticipated, providers may lack the ability to implement these mechanisms, and primary care providers are in short supply. As in the 1990s, success depends on targeting specific populations, such as people with multiple chronic conditions who need and may benefit from coordinated care.Keywords
This publication has 13 references indexed in Scilit:
- The Long-Term Effect of Premier Pay for Performance on Patient OutcomesNew England Journal of Medicine, 2012
- The Role Of Nurse Practitioners In Reinventing Primary CareHealth Affairs, 2010
- The Group Health Medical Home At Year Two: Cost Savings, Higher Patient Satisfaction, And Less Burnout For ProvidersHealth Affairs, 2010
- Effects of Care Coordination on Hospitalization, Quality of Care, and Health Care Expenditures Among Medicare BeneficiariesJAMA, 2009
- Disease Management For Chronically Ill Beneficiaries In Traditional MedicareHealth Affairs, 2009
- Hospital‐Physician Collaboration: Landscape of Economic Integration and Impact on Clinical IntegrationThe Milbank Quarterly, 2008
- The Triple Aim: Care, Health, And CostHealth Affairs, 2008
- Unintended Consequences of Information Technologies in Health Care--An Interactive Sociotechnical AnalysisJournal of the American Medical Informatics Association, 2007
- Care Patterns in Medicare and Their Implications for Pay for PerformanceNew England Journal of Medicine, 2007
- Integrated Delivery Networks: A Detour On The Road To Integrated Health Care?Health Affairs, 2002