Survey: Health execs, payors wary of ACOs

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Executives of hospitals and health systems as well as payor organizations are taking a wait-and-see approach to participation in the Centers for Medicare & Medicaid Services’ Medicare Shared Savings Program (MSSP), commonly referred to as the Medicare accountable care organization (ACO) program. Most want more information about the ACO business model, according to three polls conducted by KPMG, EpsteinBeckerGreen and JHD Group.

In webcast polls conducted in April, 39 percent of the hospital and health system executives surveyed didn’t know their organization’s position on MSSP participation, while another 25 percent said their organization would be “watching and waiting” and would not meet a Jan. 1, 2012 launch of the program under current proposed rules, New York City-based KPMG stated.

Fifteen percent said they needed to further build out their ACOs and expected to file later, while 17 percent of hospital and health system respondents said they expected to file with CMS in time to launch their ACOs by the Jan. 1 deadline.

Nearly half of payor respondents said they didn’t know their organization’s position on MSSP participation, while 21 percent said they would be watching and waiting. Fifteen percent said they needed to further build out their ACOs and expected to file later. Ten percent said they would be a first-wave player and expected to file with CMS in time to implement by Jan. 1, 2012.

Healthcare leaders want to better understand the implications of an ACO business model, KPMG stated. Sixty-two percent of hospital and health system respondents said their organizations have started to determine whether they will participate in an ACO. At the other end of the spectrum, 9 percent said their organizations are not interested in participating.

Physician participation was a major consideration. In launching an ACO, 36 percent of hospital and health system respondents cited physician buy-in as the greatest challenge, followed by cost (31 percent), staff and skill sets (22 percent) and management buy-in (11 percent). Payor respondents cited the same challenges in the same order, according to KPMG.

Sixty-six percent of hospital and health system respondents said it will take at least a year or more to create an ACO. Many also felt that return on investment would be delayed, with 65 percent of hospital and health system respondents saying that it would take 25 months or more to see a return.

The KPMG Healthcare & Pharmaceutical Institute, law firm EpsteinBeckerGreen and consulting firm JHD Group conducted a three-part webcast series on accountable care on April 12, 19 and 26, netting about 3,000 respondents. The results reflect responses from about 140 hospital and health system leaders and close to 50 payor leaders who self-selected to participate in the webcast polls. Respondents included senior executives who have awareness of, or responsibility for, their organizations’ financial programs.