ACOs and Physician Leaders: Two Perspectives—Part 1

Guest blog by Christine Mackey-Ross

The move toward Accountable Care Organizations (ACOs) is in full swing. Health care leaders are considering a variety of approaches to realigning or even reconceiving existing organizations to fit new models. I recently interviewed two noted physician executives—John B. Chessare, MD, President and CEO, Greater Baltimore Medical Center (GBMC), and S. Rockwell Fredrickson, MD, President and managing director of physician integration of Integris Physicians Services (IPS) in Oklahoma City—to gain their insights.

In this post, I’ll share their thinking on how their own organizations plan to thrive in this new world.

One seismic shift, two approaches to change

Drs. Chessare and Fredrickson both acknowledged the enormous challenge of transforming from a hospital-centric to a patient-centric model of care. But their organizations’ approaches to change are distinctly different.

“My organization is hospital-centric,” said Dr. Chessare. “We own a 40-FTE primary care physician company, and another 200 primary care doctors work with our hospital at varying levels of alignment. One of our first steps is to figure out the best model to get all of them linked in.”

According to Dr. Chessare, GBMC is transforming its employed model, making its primary care sites better able to accept risk. The medical center’s goal is to be ready to sign up as a level-one ACO this year and be prepared for operations by the beginning of 2012.

In Oklahoma City, on the other hand, IPS plans to offer an independent, rather than employee-only, model in a clinical integration system. But, he cautioned, integrated delivery systems aren’t guaranteed success as ACOs, because integrated delivery systems are not always integrated.

“Physicians are the key to the ACO,” he said. “They can contract the services; they can get the payment and coordinate care in an ambulatory setting. If a patient needs to be hospitalized, they can do that through contractual means. This is going to be an ambulatory-centered world with the patient at the center of care.”

A patient-centric model of care

Both doctors agreed that U.S. health care is moving toward a patient-centric model of care. “We have to make a giant leap from one business model—a transactional, volume-based system—to one of performance-based, bundled care,” said Dr. Frederickson.

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