On January 30, New York Times op-ed columnist Ezekiel J. Emanuel and Jeffrey B. Liebman, a professor of public policy at Harvard, published what they called “a bold prediction for the new year."
“By 2020, the American health insurance industry will be extinct,” they write. “Insurance companies will be replaced by accountable care organizations—groups of doctors, hospitals and other health care providers who come together to provide the full range of medical care for patients.”
ACOs' developing structures
Private sector ACO forms are still evolving. "There is no single definition of ACO. They can mean anything between an insurance company and a physician group practice, or a group practice and hospital," says Anders Gilberg, senior vice president for government affairs at the Medical Group Management Association in Washington, D.C.
More business integration could also mean fewer consumer choices, which might worsen existing cost problems.
It's not clear how entities that work together in an ACO should share savings, Kase says. If a referring physician retains more savings than do other practitioners, anti-kickback laws might apply.