Absolutely not. An Accountable Care Organization (ACO) is a group of public or private healthcare entities that develop, adopt, and implement a healthcare payment and delivery model that ties doctors’ reimbursements both to quality metrics and to reductions in the total cost of healthcare delivery for an assigned population of patients. Doctors who own or participate in an ACO are incentivized financially both to provide excellent healthcare and to reduce the cost of the healthcare delivered to their patients. In a very real sense, doctors who own or participate in ACOs quite clearly and inherently place themselves at conflict with the interests of their patients. They make themselves arguably more accountable to the ACO and to health insurance companies by having to comply at the highest level with the methods, protocols, and procedures of cost containment established and required by the ACO than they are accountable to their patients whose true healthcare needs may lie outside of acceptable parameters established by the ACO. In other words, ACO doctors get paid more by insurance companies when they reduce the cost of your healthcare (i.e. restrict or withhold certain services) while trying to keep their patients healthy. At Summit Medicine and Pediatrics, we always place the healthcare interests of our patients first. Dr. Mike is primarily, fully, and completely accountable to his patients ONLY, regardless of whether or not cost-savings measures suggested by health insurance companies or ACOs are applicable or appropriate for implementation in his patients’ plan of care.
