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leakage

Patient ā€œLeakageā€: Rethinking Two Field of Dreams Assumptions About ACOs

A study released last week by the Massachusetts Attorney General containsĀ surprising data to challenge two commonly heldĀ ACO (accountable care organization)Ā “Field of Dreams” assumptions. These assumptions relate to patientĀ “leakage” ā€” out-of-network patient care and referrals.

1) Hospital administrators assume that tighter physician-hospital integration (e.g., through employment of physicians) will result inĀ “captive referrals” by physicians back to the mother-ship hospital.

2) Medicare administrators are assuming that Medicare Shared Savings ACOs will be able to coordinate patient care even without limitations on patients’Ā choice to go […]