Shared Savings Program for Accountable Care Organizations: A Bridge to Nowhere? – Nice analysis of some of the challenges of Accountable Care Organizations by Bob Berenson.
The discussion about invisible assignment is interesting to me – it basically says “if patients don’t know that they are part of a group whose costs are being closely monitored, they might receive different care without their knowledge, so therefore, we need to tell them up front that they are in this special group, so they can be on the lookout.”
This seems like a possibility especially if patients don’t have access to their medical record information. So, I would ask,”what if patients had complete on-demand access to their medical reocrds/progress notes” across the board, whether they are in this group (“Accountable Care Organization”) or not? What would happen then – would it be easier for patients to make comparisons about the way they are being treated and thus provide a counter-balance to the feared tendency to treat people differently? In other words – “if the customer knows what you’re doing, you will be more likely to work with their best interests in mind.” / more information is better.
What do others think?