In Health Affairs blog posts today, commentators Steven Lieberman, president of Lieberman Consulting, Inc., and a visiting scholar at the Brookings Institution’s Engelberg Center for Health Care Reform, and Douglas Hastings, health law expert from Epstein Becker & Green, P.C., analyze the Pioneer Accountable Care Organizations announced by the Centers for Medicare and Medicaid Services on May 17.

Lieberman concludes in his posting:

“The enthusiasm around ACOs provides a rare opportunity to institute real change, supported by accountability, measurement of clinical and financial performance, and better aligning of economic incentives.  As anyone who has attempted it knows, changing provider culture and improving clinical processes requires persistence, time, and exhausting attention to detail, as well as a tolerance for making – and correcting – mistakes.  Creating successful systems of care is, quite simply, hard, slow work.

Insisting on rapid progress and setting overly ambitious targets is not only unrealistic but will almost assuredly result in failure.  The policy choice for CMS is not between perfect and imperfect ACOs.  Rather, the choice is between getting started building systems of care – whose performance can be measured and which can be improved over time – and remaining stuck with fee-for-service.”



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