“Medicare is the industry leader." The government insurer sets the quality standards that the ACO measures.
As far as reducing costs, Kane is precise in his language, “ACOs moderate the increase in costs,” he said. It’s
unlikely that the costs will be less, but instead of costs going up by, say, 7 percent, with an ACO the costs might
be 2 percent.
Although the ACO receives money from the insurers to help pay for the care management they provide, it still
isn’t making up for the lost volume to the hospital. While keeping patients well and out of the hospital is good
for both the patient and the system, hospitals are smarting from the loss in revenue.
“That’s one of the most significant questions facing hospitals,” Kane said. “We’ve improved quality and we’re
reducing utilization and cost, but we still have a long way to go.”
Central Maine Healthcare ACO
