The California Medical Association defines an ACO as “a collection of physicians who join together to coordinate care, share clinical information and report on quality measures.” A key part of healthcare reform, ACOs are intended to improve the quality of patient care. In theory this improvement may translate to improved claims experience (e.g. fewer and less severe claims) over the long term. Thereby resulting in favorable treatment on the part of insurance carriers such as The Doctors Company, Norcal Mutual, and Medical Protective. In other words, insurance carriers may be willing to offer ACOs lower insurance premiums for their member physicians gambling that the ACOs will in fact deliver improved patient care leading to lower overall claim.
This was the hope back in the day when IPAs touted improved patient delivery systems. In the case of IPAs favorable claim outcomes never materialized. Will the same happen with ACOs? Time will tell but in the interim we are working to take advantage of the possibility of lower rates from the nations best companies by developing group purchasing programs for our ACO clients.