AHCJ Health Policy Resources
Affordable Care Act: The politics of health care, year two
Meeting the challenges of explaining Health Policy
The Affordable Care Act: What to cover at the one-year mark
Officials, health system administrator discuss challenges, 
implementation of the Affordable Care Act, Feb. 24, 2011 (audio available)
Health care reform has passed: What’s next? Suggestions from four reporters on how to approach the topic
Covering high-risk insurance pools: Four reporters who have covered the topic offer story tips, suggestions and resources.
What’s next? Reporting on Health Policy between now and 2014: Transcipt of a briefing co-sponsored by AHCJ and related resources
Toolkit: Fresh Ideas for Reporting on Health Policy: Story ideas, reform timelines, expert sources and resources to help you cover implementation.
‘Landmark:’ Behind the scenes of covering health care reform: Joanne Kenen interviews two of the authors of a book about about how the ACA evolved and how it will affect individuals, small businesses and insurers.
By Shannon Muchmore
Tulsa World
Accountable care organizations, a key component of federal Health Policy, may be unsustainable and not financially viable, but some examples show the method has the potential for success.
Regardless, ACOs are a complicated, important topic that health care journalists should take time to explain and investigate, according reporters and health professionals said in a panel titled "What you need to know about accountable care organizations" at Health Journalism 2011.
ACOs are networks of doctors, hospitals and insurers that are responsible for the same set of patients and share Medicare savings from the efficiencies the system of care allows, provided they meet certain stringent quality measures.
Brookings Institution scholar Steve Lieberman and University of Pennsylvania Professor Lawton Burns argued that ACOs will have little or no economic return and require quality measures that are too difficult to attain in the timeline provided by law.
"Providers are going to have to pull of all of these different changes they've never been able to pull off before" Burns said.
Lieberman said ACOs will struggle to be ready by January 2013 and have almost no chance of meeting the stated goal of starting up in January 2012.
Katherine Schneider, senior vice president for AtlantiCare, however, argued that her company's Special Care Center in Atlantic City offers a glimpse of how an ACO can be organized and quickly begin providing better care at a lower cost despite the radical change in practice.
"Some of this actually can be done," Schneider said. "It's a little like David and Goliath, but it can happen."
The center, which opened in July 2007, uses a patient-centered team approach along with electronic health records to attempt to eliminate cultural disparities in health care.
It has an on-site pharmacy, 10 exam rooms and 24-hour phone access to care. Staff meet every morning to discuss frequent patients and any overnight calls or problems.
The approach has lowered readmission rates, reduced the prevalence of smoking and lowered blood pressure in patients, Schneider said.
Staff has become more accountable and patients with chronic illnesses are showing improvement, she said.
"This is primary care version 2.0 here," she said.
Kaiser Health News reporter Jenny Gold said journalists should be asking health care providers in their communities whether they are creating ACOs and how they plan to make them work.
She likened the notoriously complicated system of care to the mythical race of unicorns.
"We all know what they're supposed to look like, but we've never seen one," Gold said.
She suggested reporters find out whether hospitals in their area are buying up physician practices and ask what patients will find different about being part of an ACO.
If no providers are planning an ACO, that is also a story, as is the potential for small communities to find fewer choices if local providers join together in an ACO.
Reporters should ask what specific measures the providers are taking to meet the quality standards required by ACO regulations, not just take the hospital's word that an ACO is coming, Gold said.
"If I were you I would really take that with a grain of salt," she said. "Everyone wants to be the first ACO in their community."
The panelists said they differed on their optimism for ACO success, but had many of the same opinions on what challenges are ahead for hospitals and what will determine whether the experiment will be a success.
