Interesting (and perhaps correct) predictions.
While a change to the financial motivations–from reimbursement for procedures (which leads to volume) to funding based on clinical outcomes, quality of care and savings achieved–is admirable, the issue of change management looms. If the systems changes, but those in the system do not, what is accomplished?
Also, one thing I still have to figure out (more reading needed) is how an ACO serving a statistically high elderly or obese or otherwise higher health risk population is compared to one that serves a relatively young and healthy population. Is there some form of “base line” measurement done and the ACO is measured based on improvement from there?