Will Accountable Care organizations have a positive impacat on oncology and patients with cancer

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The delivery model of integrated care, or ACOs, has become a very popular solution to several of the challenges we face in medical care. The ability of that system to improve cancer care is a little bit unclear right now.

This is not exclusive to cancer care. I think it’s true of all subspecialty care. The way that the subspecialists and their expertise fit in with the structure of what is predominantly a primary care delivery model has yet to be largely defined. We talk about this all the time.

To some extent, we say, “If we can make an oncology practice really function well as a patient?centered medical home, that is exactly the kind of practice that will succeed in an ACO model.” That’s true from the oncology practice perspective. Viewing it the other way, from the ACO perspective, I’m not so sure that they’ve gotten to that point, yet.

I think the ACOs that are most mature are still struggling with that primary care delivery model. They aspire to handle the subspecialty care. Oncology may be a good case because it’s very episodic, more precisely, a series of episodes, but we’re not there yet.