Who watches the Watchmen?

Did you know a selfless group of doctors, hospitals, and health care providers volunteered to try and provide high-quality cancer care at lower costs by joining experimental accountable care organizations (ACO)? And they accomplished just that over the first two years of transition. Only caveat is: so did everyone else. This study takes a look at spending and patterns of care for Medicare beneficiaries treated by ACO versus non-ACO providers. First, there were some tiny changes in healthcare utilization (the noble cause) within groups, but ACO providers used basically the same amount of chemo, radiation, and hospice services as their non-ACO counterparts. When it came to nickels and dimes, there were significant decreases in spending over the two years...but it was equal between the ACO and non-ACO providers. And while everybody cut spending on GI, GU, and lung cancer, they cranked up spending on breast cancer. Perhaps all this talk about accountable care made everyone behave more accountably. TBL: The initial implementation of ACOs among oncology providers did not meaningfully change practice patterns or reduce costs. | Lam, J Clin Oncol 2018