A case study and survey conducted by researchers from the Baylor College of Medicine found that Accountable Care Organizations (ACOs) tend to exclude surgical procedures in their strategy plans.
James M. Dupree, lead author of the study and a urologist from Baylor College of Medicine, and his colleagues conducted case studies of four ACOs back in 2012, as well as a survey of 59 Medicare ACOs during the program's first year. The survey had 30 respondents.
Results of the study revealed that surgery was excluded in the ACO's strategy plan during its first years of implementation. This finding was reflected by all the case studies and 86 percent of the survey participants. Both case studies and the survey respondents rated surgery with medium low, low, or very low priorities.
The researchers were not surprised with their findings, as ACOs do not have quality metrics focusing on surgery. But the team was positive that ACOs would likely shift their priorities to include surgery through time.
"Any thoughtful leader has a laundry list of things a mile long that they'd like to work on, and working with the surgeons and the specialists just isn't at the top of the list. It's something they'd like to do later on," David Muhlestein of consulting firm Leavitt Partners told MedPage Today.
Muhlestein also added that surgeons were not the only group ignored by ACOs. He noted that endocrinologists, dermatologists, and many other expertises were also excluded in most ACOs. Most ACOs focused on decreasing the number of costly admissions by managing the health care plan of patients with chronic illnesses such as diabetes.
Another reason why ACOs tend to ignore surgeons is due to the difficulties associated with creating a savings plan that they could share with specialists.
"It's harder with specialists who may only see a handful of patients a week," Muhlestein told MedPage Today.
Further details of the study were published in the June 8 issue of Health Affairs.
