60% of practices not moving to accountable care

The majority of physician practices have not joined an accountable care organization and don't plan to, according to a study published online in the journal Health Services Research.

These practices avoiding ACOS also are less likely to have the resources, such as EHRs, care coordinators and quality improvement initiatives, to effectively manage the costs and care for chronically ill patients, the study said.

Approximately 60 percent of physician groups have avoided accountable care to date. One-quarter of survey respondents already were in ACOs and another 15 percent planned to join an ACO.

Medicare's accountable care efforts, launched in 2012 under the Patient Protection and Affordable Care Act, now include more than 350 organizations. And, private insurers have entered into more than 600 accountable care contracts.

Success for these early adopters could encourage stragglers to make the investment and preparations necessary to transition to accountable care, the authors wrote. “Early formative evaluations of pilot sites highlight the challenges of building capabilities in electronic health record functionality, predictive analytics, data collection reporting and analysis, care management, physician and patient engagement, and the key roles played by culture and leadership.”

Accountable care practices were more likely to have 100 or more doctors and were less likely to be owned by a hospital, according to the survey. “Our findings also suggest that those practices owned by hospital and health systems may be reluctant participants given that the new value-based payment models are likely to adversely affect hospital admissions and financial viability.”