Can we, please, get a better name than 'accountable care'?

March 17, 2014
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Health care has a branding problem right now.

I’m not talking about the individual health care businesses. (I mean, the fact that the former Clarian Health hospital system convinced Indiana University to let it use its name should go down in history as a great branding coup—at least for the hospital.)

What I mean is that the health care system is going through transformative change—but is doing so under some of the most sleep-inducing names possible.

If Shakespeare were assigned to write about health care in the 21st Century, he’d quip, “Could an ACO by any other name possibly be as dull?”

This became an issue a couple weeks ago when I told my editor that I had a scoop on Franciscan Alliance and Anthem Blue Cross and Blue Shield forming Indiana’s first accountable care organization, or ACO, for commercially insured patients.

“The words ‘accountable care’ and ‘ACO’ make my eyes glaze over,” he said to me. “But I know this is supposed to be important, so go ahead and write about it.”

“Accountable care” has come to serve as an umbrella for various concepts in health care, all of which have soporific monikers.

Pay-for-performance, or P4P

Value-based purchasing

Shared savings

Bundled payments

Second curve

Some people try to use labels like “value-based care” or “population health” or “pay-for-value” as replacements for accountable care. But those names are almost equally vague or punchless or both.

This is too bad because, as I have explained here, this shift to accountable care is a positive change like we haven’t seen in health care in the past 50 years.

Think about it: As recently as five years ago, hospitals attacked new markets by building hugely expensive medical facilities, like those at Exit 10 in Fishers. But as accountable care or value-based care or whatever you want to call it spreads, it is rendering any hospital facility as cost center, which the hospitals will try to avoid sending patients to as often as they can.

Said another way, accountable care is forcing hospitals to get out of the hospital business—at least when we define hospitals as a place where sick patients spend the night to receive medical care.

So, because the dull names are masking the dramatic reality, I tried to come with a few alternatives that are punchier and more descriptive. Some of these are serious and some are tongue in cheek. Some are labels and some are taglines to marketing campaigns I could see hospitals and doctors running.

Hurry in! Aspirin now costs just $3.75 per pill.

Prices slashed! We’ll only charge you an arm this time.

Actually-paying-attention-to-cost care

Finally, doing no harm—to your wallet

No-more-bankruptcy care

Cost-sensitive care

Money-saving medicine

High quality, low cost care

Healthy bodies, healthy budgets

After reading my list, feel free to suggest a few of your own.


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  1. These liberals are out of control. They want to drive our economy into the ground and double and triple our electric bills. Sierra Club, stay out of Indy!

  2. These activist liberal judges have gotten out of control. Thankfully we have a sensible supreme court that overturns their absurd rulings!

  3. Maybe they shouldn't be throwing money at the IRL or whatever they call it now. Probably should save that money for actual operations.

  4. For you central Indiana folks that don't know what a good pizza is, Aurelio's will take care of that. There are some good pizza places in central Indiana but nothing like this!!!

  5. I am troubled with this whole string of comments as I am not sure anyone pointed out that many of the "high paying" positions have been eliminated identified by asterisks as of fiscal year 2012. That indicates to me that the hospitals are making responsible yet difficult decisions and eliminating heavy paying positions. To make this more problematic, we have created a society of "entitlement" where individuals believe they should receive free services at no cost to them. I have yet to get a house repair done at no cost nor have I taken my car that is out of warranty for repair for free repair expecting the government to pay for it even though it is the second largest investment one makes in their life besides purchasing a home. Yet, we continue to hear verbal and aggressive abuse from the consumer who expects free services and have to reward them as a result of HCAHPS surveys which we have no influence over as it is 3rd party required by CMS. Peel the onion and get to the root of the will find that society has created the problem and our current political landscape and not the people who were fortunate to lead healthcare in the right direction before becoming distorted. As a side note, I had a friend sit in an ED in Canada for nearly two days prior to being evaluated and then finally...3 months later got a CT of the head. You pay for what you get...