Health Care Reform Requires Accountable Care Systems

Health care reform requires more than expanding health insurance to cover all Americans, it also involves making sure such coverage is affordable. The authors of this paper propose the concept of accountable care systems (ACS). An ACS is an entity that implements organized processes for improving the quality and controlling the costs of health care, as well as being held accountable for the results. The paper proposes five ACS models: (1) Multispecialty Group Practice; (2) Hospital Medical Staff Organization; (3) Physician-Hospital Organization; (4) Interdependent Practice Organization; and (5) Health Plan Provider Organization or Network.

The authors suggest a variety of ways for implementation.

  • Patients could be encouraged to select an ACS as their medical home.
  • Physicians would not be required to join an ACS.
  • Physicians and hospitals that are part of an ACS could be rewarded more generously if they improve the quality and care of their patients.
  • Tiered incentives could be created for patients to choose the highest add-value ACSs for care based on available data.
  • A change in laws and regulations would be necessary to permit greater flexibility in developing new practices.

In the future, ACSs may offer health care organizations and patients a way to meet today's health care challenges.