Are Single-Specialty ACOs In Your Future?

AIS's Health Business Daily: "US Oncology May Go National With Private-Sector Accountable Care Organization."

"Leonard Kalman, M.D., who is one of several medical directors for the huge for-profit oncology practice-management firm and chairman of the board of managers of Miami-based Advanced Medical Specialties, says that he thinks US Oncology-affiliated practices as a whole, including his, are interested in exploring such commercial ACO-like ventures. In fact, he says, a major hospital in Miami has approached his 40-physician practice about handling cancer care in such a way. “Our ACO partner is a dominant hospital system where we put basically all of our patients,” he says, declining to name it.

"When cancer becomes the primary diagnosis, the oncologist basically handles the patient’s primary care, Kalman explains. “Remember, the majority of an oncology patient’s care is cancer care,” he says. So while ACO patients may require occasional care from other sources, including primary care physicians or specialists such as cardiologists or rheumatologists, only oncologists would be affiliated with a Medicare oncology ACO as he envisions it."

An intriguing idea, though I'm hearing echoes of mid-1990's style risk contracting where specialty carve-outs were common and, ultimately, counterproductive.   An "every specialty for himself" model, where the impetus is simply preserving market dominance and pricing power, further fragments care to nobody's benefit, least of all the patient's.  The more THAT happens, the more the entire system is put at risk.