With integrated medical records and a goal to coordinate patient care, Ortiz said, the ACO concept will give primary care physicians a chance to reclaim a leading role in healthcare, as opposed to specialists driving the care.
We saw a small window of opportunity for the primary care physician to go back to center stage, he said, adding that the group has identified a lot of low-hanging fruit in the ACO concept, such as opportunities for managing chronic diseases, and even delivering care to patients at home.
Though groups of specialists also have formed ACOs, Saavedra said he believes that many patients seek the care of specialists when a primary care physician will do.
My experience is that sometimes people think, I need to see a cardiologist, he said, and my question to them is, Do you have heart disease? Their answer is, No. I dont. But I want to make sure I dont.
Physicians in the PrimeHealth group will provide extended care hours, weekend hours, home visits, nursing home visits and hospitalist services. And the group will use economies of scale to find savings on everything from medical supplies to office equipment.
Were able as a large group to negotiate better rates, said Ortiz, who added that PrimeHealths goal is to bring 75 physicians into the group, with 50 by summers end.
While ACOs are intended to improve quality and lower costs, though, its important to remember that the groups are still an experiment, said Goodman, the FAU teacher.
The jury is still out as to whether doctors and providers with different incentives in mind can, in fact, collaborate, she said. Its an experiment.
As with any experiment, Goodman said, there are risks of failure.
Ortiz said the process of merging dozens of independent physician practices under a single entity with one human resources department, one billing system and shared systems for electronic medical records and data gathering must be done seamlessly or risk failure.
If we dont do it the right way, he said, we could implode.
Goodman said her concerns include the incentive for hospitals and providers to consolidate into ever larger groups, which could run afoul of anti-trust laws or encounter other legal barriers.
Economies of scale get better the larger you get, she said, and you can be more experimental if you have a lot of economies of scale to work on.
Already, there is evidence that ACOs have helped slow increases in medical costs and reduced emergency room visits. But they also appear not to be for everyone.
This week, federal health officials reported on the results of 32 organizations selected in April 2012 to participate in the Pioneer ACO model, which was designed for groups already experienced with coordinated care.
According to the Centers for Medicare & Medicaid Services, the program showed improved patient health and lowered costs.
For the more than 669,000 Medicare beneficiaries who participated, costs grew by 0.3 percent in 2012 compared to costs for similar Medicare beneficiaries that grew by 0.8 percent during the same period.
But nine of those 32 organizations also announced their intention to leave the program after the first year of the three-year program, which was voluntary. Seven of those nine will participate in the Medicare Shared Savings Program, another ACO model with less risk of losses.