Barriers to the launch of accountable care identified

(HealthDay)—Health care reform presents a unique opportunity for medical health centers to integrate systems of care, such as accountable care organizations (ACOs), but not without facing several barriers to implementation, according to an academic health center profile published in the November issue of Health Affairs.

Alfred F. Tallia, M.D., M.P.H., and Jenna Howard, Ph.D., from the Robert Wood Johnson Medical School in New Brunswick, N.J., describe the ongoing efforts to develop an ACO at their academic health center, and the barriers encountered during this process.

The researchers report a three-phase approach to ACO development thus far. Stage one involved creation of a business plan, which was modified in stage two, following discussions with local physician organizations, insurers, government and business leaders, and national and local health care policy leaders. Stage three, which is ongoing, involved readying for implementation, mainly identifying funding for an integrated delivery system. Six main types of barriers were encountered during the ACO development: conceptual, financial, cultural, regulatory, organizational, and historical.

"Academic health centers such as ours have a unique opportunity now to reinvent themselves and lead the discovery and testing of new systems of health care organization and delivery," the authors write. "We have presented some of the challenges to our ACO formation and our ways of answering them, in the hope that other academic health centers can learn from our experience."