With the passing of the Affordable Care Act (ACA), this nation has seen the beginning of a dramatic shift in both the delivery of healthcare and the means by which payment is made for medical services.  Under the ACA, a new type of medical agency was created, known as Accountable Care Organizations (ACO). These entities are required to coordinate all levels of care in a fashion that is both more efficient and better focused on the provision of quality care.

As we have written on our blog, hospitals will no longer be paid to rectify medical errors which have been deemed as “never events.” This is a class of medical error which non-profit research groups and the federal government alike have determined to be wholly unacceptable in the hospital context. ACO’s are being organized to help prevent the occurrence of never events.

At present, we may be at a crossroads in terms of whether ACO’s will be lead by physicians or hospitals.  Either scenario has its share of opportunities and pitfalls. The New England Journal of Medicine has been following ACO issues and includes some excellent commentary.