A new study by the California HealthCare Foundation says large, well-organized multi-specialty practices are poised to take healthcare costs and quality to a new level through accountable care organizations.
The study compared the costs and quality of care delivered to fee-for-service Medicare beneficiaries in 22 healthcare markets by physicians in small group practices to those in multi-specialty groups of 250 to 13,000 physicians.
The study revealed that large multi-specialty group practices improved the quality of care by 5 percent to 15 percent with a 3.6 percent ($272) lower annual cost per patient. While the Medicare cost savings were relatively small, the study found that if all physicians performed at this level, the Medicare program could yield $15 billion per year in savings.
The findings support the growing argument that large multi-specialty group practices, with infrastructure already in place, are well positioned to serve as accountable care organizations, or ACOs.
William Weeks, MD, of the Dartmouth Institute for Health Policy and Clinical Practice and lead researcher of the study said, "given where healthcare is headed with healthcare reform, it makes sense that large group practices begin to participate in accountable care models."
The ACO trend seems to be spreading. On May 21, the Premier healthcare alliance launched two collaboratives designed to help hospital systems prepare to participate in ACOs.
The Premier collaboratives will include 19 health systems in 15 states, involving 70 hospitals, more than 5,000 physicians and 1.2 million patients, according to Premier president and CEO Susan DeVore.
At a May 21 press conference, DeVore called ACOs "the next layer in healthcare."
"ACOs are a departure from the status quo and will be an ambitious goal for even the most advanced healthcare systems," DeVore said. "Ultimately, Medicare will join existing ACOs."
Billings Clinic in Billings, Mont., will be a participant in one of Premier's new ACO collaboratives. Billings CEO Nicholas Wolter, MD, said many healthcare systems have eyed integrated delivery models for years as a way to boost patient involvement in preventing chronic diseases.
"This era of post-healthcare reform is creating the right circumstances," Wolter said. "It will provide the means to activate patients in new and creative ways."