A survey of physicians participating in Medicare accountable care organizations (ACOs) revealed that approximately one-third to one-half of the physicians did not know if they or their practice were at risk for financial losses because of their participation; the results varied by the type of ACO model.

Conducted from September 2014 through April 2015, the survey included 405 physicians in the Medicare Shared Savings Program (MSSP), 549 in the Advance Payment Model (AP) and 447 in the Pioneer model. Just under half of those in the MSSP and Pioneer ACOs were not aware of whether they had a downside financial risk, and 36.5 percent of those in AP ACOs were not aware. Similar proportions indicated that they were unaware of whether they were eligible to receive shared savings.

Physicians in the AP ACOs “had more favorable views of the ACO model in general and their ACO’s positive effects on patient care,” as compared with physicians in MSSP and Pioneer ACOs, the authors of the survey report noted, adding that the difference in responses may have been associated with the types of physicians who participated in each model, the amount of previous experience they had with efforts to transform health care or whether they were involved in the decision to participate in the ACO, rather than with the ACO models themselves.

“[T]he results of our survey suggest that many participating physicians’ views are not aligned with ACO goals and that the physicians are divided as to whether or not the ACO model is effective,” the authors wrote.

The findings were published in the April issue of Health Affairs.

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