Physicians show strong leadership in US accountable care organizations but surgeons are largely left out

Physicians are assuming strong leadership roles in the new accountable care organizations (ACOs), but the organizations appear to be paying little attention to surgical care, two new studies in the journal Health Affairs have said.1 2

ACOs are groups of providers who enter a contract to care for a set group of patients and, in return for containing costs and meeting specific quality goals, receive financial rewards such as bonuses or a share in the savings that they generate. Proponents of the ACOs have said that the organizations create an alternative to the highly fragmented, fee for service model that currently dominates the US healthcare delivery system and will provide more cost effective, comprehensive, coordinated care.

The 2010 Affordable Care Act created a voluntary ACO program for Medicare, the US health insurance plan for elderly and disabled people, but many private insurers have also adopted the model. More than 600 ACOs operate in the United States.

In the first study Carrie H Colla, of the Dartmouth Institute for Health Policy and Clinical Practice …