In the near term, there is likely to be a range of ACO models, Dr. Crosson predicted. Some will be tightly constructed around integrated delivery systems in which physicians and hospitals are part of the same economic entity. Other will be looser models that bring together a group of physicians and hospitals that are financially separate from one another, he said. The real question, Dr. Crosson noted, is not whether various models can be designed, but which ones will work best.
But he added that pediatricians will have a role, especially if they have had success in transitioning to a patient-centered medical home practice. The type of care coordination that happens at the individual practice level is the same type of capability a physician will need to be successful within an ACO. "I think there's room in this for virtually everyone to be in the game and try to get it to work."
As the ACO concept develops, pediatricians may find that they are getting a lot more attention from hospitals that are interested in developing closer, more collaborative relationships with them, said Dr. Allen of Nationwide Children's Hospital. "I think [pediatricians] are going to find themselves to be incredibly popular."
Naseem S. Miller contributed to this report.