I am on an email list of Bill DeMarco’s, a reputable industry insider who has written and consulted extensively in the physician group and medical management space. He recently sent me a note about several physician aggregation events in New Jersey.
For some reason it struck a nerve with me . . . which led me to fire off the response below:
Bill,
I thought we already saw this movie?
My question for you . . . besides banding together in some megagroup – what are these physicians doing to actual change the delivery of medicine? ACO is just the latest buzzword excuse to aggregate physicians under a new moniker and a supposed new model.
I am highly suspect that these physicians are doing anything to change the relationship with their patients, to use enabling technology to create team based care, or actually be accountable for the outcomes they produce. What systems are they using to tie themselves together? What financial alignment do they have? What measures are they using to demonstrate superior outcomes? What about the patient experience – 7 minute visits that push pills as the “treatment” won’t get it done in the future.
I think your closing statement, “Representatives from Summit and Optimus were unavailable for comment” says it all.
Am I seeing this the wrong way? Is there anything new about this model this time around? Am I getting old enough to see these things cycle through?
PS – and no, I don’t mean a wolf. The sheep get nervous and band together waiting to get pounced on by wolves.
Scott Shreeve, MD 
Indeed the world is cyclical in nature but that’s good as we can learn from history. You can’t disagree that PhyCor’s model worked well for a while. It seems to me their Achilles heel was the 40 year contracts which locked in clinics and enabled PhyCor to get away from their core competency. I believe current legislation dictates ACOs enter only a three year agreement with HHS.
Haha! I see 80s music is back in style!
I’ve been having the discussion with a few people lately that you could get together a group of doctors and other clinical team mates, put them in a practice that is customer experience focused and you could quite conceivably mop the floor in the market if you could scale this.
This is not about EMRs or taking patient emails or video conferencing visits, although certainly those things would be there. This is not about proactively scheduling people for standards of care, but yes, that’s there too. The most radical thing here is paying real bonuses for real improvements in health status and biometric readings. But even that’s not that radical anymore. At least in some circles.
Sure, it’s hard to put all of these pieces together and make them sing in harmony. But you wouodnt even have to get it perfect to rock the socks off of 90% of what passes as “medicine” today. ACO indeed!