Doctors Eager For Evidence About Integrated Health Systems

Doctors say they are finding more opportunities in the integrated health systems that have been touted in the federal health law, such as accountable care organizations, which are groups of health providers and hospitals that work together to improve patient care and lower costs. But they are still hesitant to change their practices without more evidence that these systems will work.

That is the assessment of health care experts at Deloitte, a consulting and professional service firm, which recently asked doctors about their views on the health law and new models for delivery of care. They sent surveys to 20,000 physicians and received 613 responses.

One in three of those responding reported familiarity with the new delivery models, and 37 percent said that ACOs would successfully achieve improved quality for some standards of patient care.

“There’s still uncertainty about how the financial side is going to play out,” said Dr. Bob Williams, a physician and national medical leader at Deloitte, about changes in the health delivery system. “But physicians also see the value in the ACA, and see the value in improving access to care.”

Williams said they found that 37 percent of doctors said that ACOs would successfully achieve improved quality for some standards of patient care.

Terry West, a health care consultant at the research and consulting firm IHS, said the low numbers could be attributed to the small sample size of the report and the lack of conclusive evidence of the systems’ benefits. But he said that physicians — and other health providers affected by new delivery models — would be more likely to embrace the changes when there is long-term proof that they work.

“I think that physicians, especially primary care physicians, will be positive and more willing to be involved with ACOs,” he said. “But others are not clear whether it will benefit their specialties.”

The most important aspect of that change, West said, would be care coordination, which some health systems have put in place to help patients manage prescriptions, multiple physicians and payment. The majority of physicians surveyed agreed that interdisciplinary teams and coordinators were “the wave of the future in medicine.”

Even without conclusive studies, seven out of ten physicians surveyed said that large health delivery systems – which include ACOs, medical homes and hospitals – would yield more financial success in the future. And Williams said that physicians were starting to collaborate in order to focus on what they voted in the survey was most important to them: patient relationships.

“There’s an optimism here, a sense of being headed in the right direction,” Williams said.