Writers in a Health Affairs blog post say the financial impact of accountable care organizations (ACOs) has produced some controversy among health authorities due to a stark contrast of opinions.
Some analysts prescribe to the idea ACOs have led to savings which could grow over time, the authors write, while others believe a new fresh take on reform is necessary due to a lack of savings.
Some of the debate, too, stems from the difficulty of envisioning a market without ACOs due to a lack of counterfactual scenarios with which to judge performance.
“While we can observe actual spending for ACO beneficiaries, it is impossible to observe the counterfactual,” the authors write. “Therefore, it’s very hard to know what would have been spent if ACOs did not exist.”
The authors also say benchmarks used by the Centers for Medicare and Medicaid Services are unreliable for evaluating ACO savings because they’re “constructed with policy goals in mind.”