• James M Dupree, Kavita Patel, Sara J Singer, Mallory West, Rui Wang, Michael J Zinner, and Joel S Weissman.
• James M. Dupree (jim.dupree@gmail.com) was a health policy fellow at the American College of Surgeons, in Chicago, Illinois, at the time this research was conducted. He is currently a male reproductive medicine and surgery fellow in the Scott Department of Urology, Baylor College of Medicine, in Houston, Texas.
• Health Aff (Millwood). 2014 Jun 1;33(6):972-9.

AbstractThe Affordable Care Act supports the growth of accountable care organizations (ACOs) as a potentially powerful model for health care delivery and payment. The model focuses on primary care. However, surgeons and other specialists have a large role to play in caring for ACOs' patients. No studies have yet investigated the role of surgical care in the ACO model. Using case studies and a survey, we examined the early experience of fifty-nine Medicare-approved ACOs in providing surgical care. We found that ACOs have so far devoted little attention to surgical care. Instead, they have emphasized coordinating care for patients with chronic conditions and reducing unnecessary hospital readmissions and ED visits. In the years to come, ACOs will likely focus more on surgical care. Some ACOs have the ability to affect surgical practice patterns through referral pressures, but local market conditions may limit ACOs' abilities to alter surgeons' behavior. Policy makers, ACO administrators, and surgeons need to be aware of these trends because they have the potential to affect the surgical care provided to ACO patients as well as the success of ACOs themselves.Project HOPE—The People-to-People Health Foundation, Inc.

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