Accountable Care Organizations (ACOs) may be rising in popularity, but many docs consider this care delivery model risky terrain.

Some recent surveys show physicians like the idea of an ACO. But when push comes to shove, it seems they'd rather someone else went first.

Seventy-four percent of physicians surveyed this spring by Jackson Healthcare will not even be considering participation in an ACO this year. (Respondents from solo practitioners or single-specialty practices skewed that percentage, as 50% of physicians from hospital-owned practices and 42% from multispecialty practices say they either will be in an ACO this year or are considering joining one.)

The reasons for the lack of involvement are not broken down by Jackson Healthcare, a healthcare staffing company, but the risks of an ACO become apparent when speaking with doctors and experts -- and by reading MedPAC's June report.

That report recommended to Congress that physicians be given more leeway when an ACO is structured in order to achieve the desired savings and quality care. Many physicians are excited about the opportunity to partner with other healthcare providers to deliver efficient care -- and of course to get their piece of the potential Shared Savings. But they're also concerned about the potential for losing money.

As the government sees it, ACOs represent the future of healthcare -- so if you want to get an early start and join an ACO now, it would require a careful vetting process. To avoid winding up in the wrong ACO, ask other participants and your own staff questions about how the ACO will be funded, the amount of financial risk involved, what the practice patterns are that optimize care and whether your data infrastructure and IT will be able to track and coordinate the new arrangement, recommends George Bone, M.D., of internal medicine practice IC Care, Largo, Md. (Bone has helped Maryland’s medical society set up two ACOs that began this month and is trying to establish a third one in his practice’s area.)

We still don’t have any conclusive data on an ACO's success rate. Until we do, we wouldn’t blame you for letting your peers serve as the test dummies.

Want more ACO coverage? Check out the latest issue of Part B News at www.partbnews.com.