When considering participation in an ACO, emergency medicine groups should pay particular attention to the following:

• Patient diagnoses and clinical metrics that indicate the need for care.
• A complete picture of the patients’ total healthcare experience, including clinical records, claims data, and information gathered from and shared with other area providers.
• Comprehensive health plan and provider performance data.
• Payer analysis across various patient populations.
• Accounting and allocation of all revenue as directed by the ACO reimbursement model.

On a broader scale, as emergency medicine navigates through the development and implementation of ACOs, leaders must remain mindful of the myriad potential effects on the specialty, including alteration in the utilization of emergency services, creation of new opportunities for care coordination, introduction of new measures of quality, and the emergence of additional threats to revenue generation.

Whether ACOs will achieve their shared savings objectives or become the dominant medical services delivery model of the future remains to be seen.

The impact ACOs will have on EM is similarly difficult to predict. However, active participation in development projects helps to ensure that emergency care will be maximally valued within these new care delivery systems.

References

1. Wiler JL, et al. Episodes of Care: Is Emergency Medicine Ready? Ann Emerg Med. 2012; 59(5):351-357.
2. Michelen W, et al. Reducing frequent flyer ED visits. J Health Care Poor Underserved 2006; 17(1):S59-69.
3. Henry Ford Health System (2010, June 3). Social factors, ‘super users’ and urban EDs. ScienceDaily. (retrieved 6/5/12; www.sciencedaily.com/releases/2010/06/100603091637.htm)
4. Porter M and Teisberg E. Redefining Health Care: Creating Value Based Competition on Results, Harvard Business School Publishing, 2006

This article was written on behalf of the ACEP Emergency Medicine Practice Committee by Heather Farley, M.D., Andrew Nugent, M.D., Laurence DesRochers, M.D., Enrique Enguidanos, M.D., Ronald Hellstern, M.D., James Cusick, M.D., Howard Mell, M.D., Daniel Freess, M.D., Michael Lee, M.D., Michael Zappa, M.D., Azita Hamedani, M.D., Leslie Zun, M.D., Shkelzen Hoxhaj, M.D., Jennifer Wiler, M.D.