A common refrain I’ve been hearing from basically every stakeholder involved in the Medicare Shared Savings Program and its accountable care organizations is that no matter what happens with the health reform law, the concept of “accountable care” isn’t going away. Lawmakers, hospitals and physician groups have been expressing concern that Medicare ACOs may not be successful. There’s also been talk about what might happen if the Supreme Court decides to throw out the entire health reform law.

Bob Belfort, an attorney at Manatt, Phelps & Phillips explained that if the law is thrown out, there may still be opportunities to resurrect some sort of shared savings system, through a combination of CMS administrative action, demonstration projects,  and new legislation (provided of course, Congress can agree on what the legislation should be). Belfort said that there is a significant percentage of lawmakers who believe in accountable care, so even if it has to wait until after the election, something could get done.   

So, the bottom line is that whatever happens with the reform law is not so important. Brent Miller, the director of federal government relations at the Marshfield Clinic, the largest group medical practice system in Wisconsin, told me there’s momentum building for organizations to become more competitive and accountable. That won’t go away just because the government mandate does. There’s broad agreement that the current system of health care delivery is inefficient and expensive, so even if PPACA is eliminated, payers and providers will still find a way to change. It just may not happen overnight.