Accountable care organizations face a persistent conundrum. They're expected to reduce overall healthcare costs by coordinating care: minimizing ineffective or duplicative services and maximizing communication among the various members of each patient's care team. They may not make money unless they can coordinate effectively.
At the same time, under current federal ACO rules, providers have no leverage to keep their attributed ACO patients from seeking care outside their network, and they may not know until well after the fact. A June 2014 study of care patterns in 145 ACOs, published in the Journal of the American Medical Association, found that 66 percent of specialist visits took place outside the ACO's network.
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