Jeremy Hunt must consult properly on accountable care organisationsBMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j5349 (Published 22 November 2017) Cite this as: BMJ 2017;359:j5349
- Allyson Pollock, professor of public health1,
- Peter Roderick, principal research associate2
- 1Newcastle University, UK
- 2Institute of Health and Society, Newcastle University, UK
The Secretary of State for Health, Jeremy Hunt, intends to change secondary legislation to enable US-style accountable care organisations (ACOs) to operate in England. He has consulted on technical changes to 12 regulations which would define ACOs and let them operate under contract. But so far there has been no public consultation about whether the law and the NHS should undergo this major change.
ACOs were conceived in the US in an effort to stem rising healthcare costs caused by fee-for-service payments and Medicare fraud in a commercial system.12 They involve government and private insurers awarding large contracts to commercial providers to run and provide services. The evidence on quality improvement is contested, and at best mixed, while projected savings to federal budgets translated into a net loss in 2015 and spending may have increased.34
NHS England (NHSE) says that it …