Don't Underestimate The Process

Accountable care will require hospitals and physicians to work collaboratively to improve the clinical process and make care more efficient (and less costly).  To accomplish this there will need to be shared leadership with, perhaps, more control in the hands of physicians.  Don't underestimate the huge paradigm shift this will require.

Hospitals will rely on their employed physician networks for the backbone of their ACO and very few of these networks have mature physician governance structures.  Add to this a mix of private practices with little or no formal management structures and you may well end up with a ship that can't sail.

How do you get from this problematic environment to Hakuna Matada ("no worries")?  Lots of trial and error.  Recently two clients started down the bonding road only to discover major potholes.  The process of ceding leadership to physicians almost derailed both.  One client decided to ignore the need for robust physician involvement and took on a risk contract without first addressing data issues, clinical process improvement, and cost of care analysis.  Are you shocked to learn that the outcome wasn't pretty?

Before you decide to begin developing your ACO take the time needed to work with the folks on the other side of the table (hospital or physician leadership) and work through control concerns and perceived threats.  Creating the vision is the easy part.  Making that vision a reality takes hard work.