Accountable care faces major obstacles in private plans

By Stephen Kemble, M.D.
Modern Healthcare, Letters, Feb. 16, 2015

Regarding the article “Where healthcare is on march to value-based care” (, Jan. 28), accountable care organizations for Medicare have struggled to achieve significant cost reductions, with more losers than winners, and even those that saved Medicare money probably cost more to administer than they saved. Moving this model to the private insurance market faces a huge obstacle in the high percentage of this population now in low actuarial-value plans with high deductibles and copayments. Those with significant chronic health conditions are often unable to afford to visit their doctors or fill their prescriptions, so providers will be hard-pressed to achieve quality metrics.

Moving the ACO model to the privately insured means holding doctors and hospitals accountable for outcomes they cannot control—a bad deal for all.

Dr. Stephen Kemble resides in Honolulu.