Duke professors argue ACOs haven’t worked

Duke University professors Kevin Schulman, MD, and Barak Richman, JD, PhD, called on the CMS Innovation Center to focus on telemedicine and wearable devices, rather than accountable care organizations (ACOs) which integrate hospitals, to reduce the cost of care.

In a JAMA Viewpoints article, Schulman and Richman said ACO programs like the Pioneer ACO model “have failed to produce needed efficiencies." They argued the problems can’t be blamed on poor implementation, with the Medicare Shared Savings Program including 220 participating organizations and another 32 involved in Pioneer ACO. The real issue, they wrote, was an incorrect hypothesis about the cost savings of ACOs.

“There have been several iterations of the ACO concept, and none appears to have meaningfully reduced the cost of care,” Schulman and Richman wrote. “Even though mere nominal savings would be important, Medicare’s financial fragility and the increasing burden of healthcare costs for the baby boom generation demand policies that bend the cost curve more substantially.”

They went as far as to say CMS should “reject the ACO hypothesis and end its interest in hospital-led strategies in healthcare.”

For more on how telemedicine and wearable devices would fit into this post-ACO strategy, click on the link below: