Will You or Your Group Participate in an ACO Arrangement in the Future? 5 Pain Management Physician ResponsesWritten by Abby Callard | January 17, 2012
Five pain management physicians discuss whether an accountable care organization arrangement might be in their future.
Laxmaiah Manchikanti, MD, Pain Management Center of Paducah (Paducah, Ky.): It is quite possible; however, it does not appear to be probable. It all depends on what happens in the 2012 elections. In the unlikely event we are forced to participate, we probably would.
Frank J. E. Falco, MD, Mid Atlantic Spine (Bear, Del.): Possibly. It's certainly something to take a good look at especially since the risk has been eliminated from one of the two ACO tracks. A lot depends on what medical environment one practices in. Large university medical systems have the financial and economy of scale resources to provide a successful ACO. In a small medical community, it will be more difficult to do.
David Kloth, MD, founder, medical director and president of Connecticut Pain Care (Danbury, Conn.): I do not think an ACO is in my best interest, but if I can't make a cash business work, I may have no choice. I am in a one-hospital town that is committed to pursuing some level of a risk-sharing model, ACO or some form of hybrid more likely. Like many hospitals, they are not happy with all of the federal requirements for a strict ACO model. It will take time, but they will continue to chip away and will likely persevere. They already control the vast majority of primary care. This is a scary and dangerous time for physicians, and anyone who does not realize it yet must be living in a dream world.
R. Andrew Robertson, MD, founder and president, Wellspring Pain Solutions (Columbus, Ind.): Utilizing a multi-disciplinary approach to pain medicine, and through careful patient contact, my practice keeps patients out of expensive settings such as emergency rooms and hospital inpatient wards. Urine drug test results at our site compared to a national database demonstrate that we do a superior job of managing this aspect of care. We would welcome a relationship with an ACO that values and rewards such a quality practice. An ACO that hopes to manage us as a cost center through command and control techniques should look elsewhere.
Marc E. Lynch, DO, medical director for Casa Colina Surgery Center (Chino, Calif.): Yes. I don’t see that we're going to have a whole lot of choice. I don’t know what the final makeup is going to be. Every time we turn around, they come up with a new adjustment to the model. The group I'm with now is already on the list to be an early adopter. I will be directly involved in it, but I'm not sure how.
This is an ongoing series which will feature five pain management physicians' responses to questions about the specialty.
Next week's question is: What was the most important pain management research in 2011?
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