Condition Specific ACOs – Perhaps Kidney and Oncology

One of the more interesting discussions out there about ACOs is that around carving out specific conditions. While the general ACO concept is built around the idea of a Medical Home where the PCP is your “guide” (not gatekeeper) and helps you to make decisions, complex patients with certain chronic conditions may be better served to have a specialist managing and coordinating their overall care.

While DaVita with their push for Kidney specific ACOs built around their focus on dialysis has been one key player here, BCBS of FL has actually come out with what they referred to as an Oncology ACO. What CMS will do here is still TBD, but the idea of taking some of these high-cost and complex conditions and putting them into a fixed fee or bundled payment structure tied to outcomes sounds right.

I personally could even see more drug companies and medical device companies playing in this area since they could directly control certain costs and often have incredible amounts of research in certain conditions.

[To see more about our physician directed Accountable Care Solutions at inVentiv Medical Management, click here. Or contact me if you’re interested in how we’re applying these to support ACO and “ACO-like” organizations in their efforts to engage consumers and drive health outcomes.]