Of ac­count­able care or­ga­ni­za­tions and car deal­er­ships

Modern Healthcare - - Front Page -

As some­one who learns more about the Pa­tient Pro­tec­tion and Af­ford­able Care Act each day, I have to say that I en­joyed read­ing the re­cent cover story (“Tests were in­con­clu­sive,” Nov. 1, p. 6) about Cal­i­for­nia’s ex­per­i­ment with ac­count­able care or­ga­ni­za­tions.

How­ever, read­ing this ar­ti­cle did raise one is­sue for me. About half­way through the ar­ti­cle, the author quoted Jerry Penso—med­i­cal di­rec­tor for the con­tin­uum of care for Sharp Rees-Stealy Med­i­cal Group and, as­sum­ingly, an author­ity on ACOs—who stated that ACOs are like car deal­er­ships. Car deal­er­ships? Now, I un­der­stand that the car deal­er­ship model pro­vides a good ex­am­ple of the ba­sic idea the author was try­ing to con­vey — that ACOs will pro­vide an all-in-one ap­proach to pa­tient care. But, is a car deal­er­ship the best ex­am­ple?

As far as I know, not all peo­ple feel as­sured with the ser­vices they re­ceive at car deal­er­ships. In fact, car deal­er­ships have been viewed as pro­vid­ing the least re­li­able ser­vices at the most ex­pense to cus­tomers. The last thing I’d like to see when read­ing about new, promis­ing as­pects of our health­care re­form is a com­par­i­son to a ser­vice in­dus­try with iden­ti­fi­able faults.

But maybe Mr. Penso’s ex­am­ple is right. Maybe ACOs are des­tined to mimic car deal­er­ships. If that’s the case, let’s just hope that our new sys­tem doesn’t en­tirely go the way of the auto in­dus­try.

James Shan­non Kitch Drutchas Wag­ner Val­i­tutti & Sher­brook Detroit

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