It is clear that the advent of Accountable Care Organizations has turned the healthcare industry upside down. The movement toward a pay-for-performance reimbursement model and away from a fee-for-service model has been over 100 years in the making. This horse has now been let out of the barn and it is not about to return anytime soon.
OK, fee-for-service may not be totally dead yet, but it is dying and it is clinging to its life by a thread. In the case of ACOs that thread must remain until its offspring is capable of standing on their own two feet.
In this case the parent must ultimately die in order for the children to live. Fee-for-service is a perverse business model that is collapsing under its own weight, and the primary reason that the U.S. spends 17% of GDP on healthcare.