title: Why are ACOs doomed for failure?
abstract: Among the more ambitious parts of the Patient Protection and Affordable Care Act (2010) is the formation of Accountable Care Organizations (ACOs) that offer fiscal rewards when well-organized, integrated hospital-physician groups can improve quality of care and reduce the cost of Medicare expenditures. After studying the conceptual and operational issues, it is concluded herein that ACOs are in the long-haul doomed for failure since: 1) most hospitals and physicians have major difficulties in consummating tightly coordinated collaborative efforts; 2) providers historically have had a dismal track record in reducing cost, because of existing fee-for-service incentives; and 3) existing regulations do not provide sufficient fiscal rewards to assume the cost of starting an ACO and its possible operational risks.
authors.affiliation: tpweil@aol.com
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Weil
mesh_terms: D060866:Accountable Care Organizations; D014487:Centers for Medicare and Medicaid Services, U.S.; D017598:Efficiency, Organizational; D018578:Hospital-Physician Relations; D058991:Patient Protection and Affordable Care Act; D011785:Quality Assurance, Health Care; D014481:United States