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As the millennium’s third decade begins, Risk has taken hold as THE strategy for tackling health care costs. Virtually overnight (in health care years) the industry has moved—albeit not uniformly—to accept Risk. This transition is already beginning to impact hospitals and hospital-based systems, and raises serious questions about the viability of their role as the primary financial engine bankrolling health care operations, reforms and modernization.
Just one year ago, the concept of provider risk in Accountable Care Organizations (ACOs) was anathema to most participants. Despite initial misgivings, however, most ACOs remained in the system after CMS pushed forward with its final rules,. To top it off, some large physician groups applauded last May’s Medicare announcement of a direct contracting method that involved a once-reviled risk-based payment mechanism—partial or global capitation. The RFP for that program has just been released for physician groups to apply by submitting letters of intent. The response is unlikely to disappoint.