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BACKGROUND:  You are the Practice Administrator of Belmont Physicians, a group of 50 primary care physicians all Board Certified in Internal Medicine. The practice started over 30 years ago and is now a thriving practice generating close to 60,000 visits a year. The majority of your patients are Medicare patients. You have been with the practice 5 years and see the impact of the changing health care landscape and understand that to retain and also increase your  patient base you have to embrace some of the changes. However, the practice has been slow to accept changes resisting for a long time contracting with managed care organizations (MCO’s).



The Medical Society of the County of Queens is supporting the establishment of an Accountable Care Organization (ACO) to be owned, comprised of, and managed by physicians based in Queens.  The Belmont Group a member of the Society has been invited to attend a meeting to learn about ACOs and  join  the ACO.  You learn that under the  AFFORDABLE CARE ACT (ACA) , ACOs are to be established to provide a framework for physicians and other healthcare providers to share in Medicare savings achieved by networks of healthcare providers who work together to better coordinate care, eliminate inefficiencies, and reduce costs. The Government is strongly encouraging physicians to participate in ACOs. The legislation gives physicians the opportunity to shape the changes in the healthcare delivery landscape. Rather than being forced into someone else’s ACO or being left out completely, the Medical Society is forming their own ACO. .



ISSUE:  You have evaluated the Medical Society proposal and want the Belmont Group to join the ACO they are forming.  You schedule a meeting to discuss the proposal with the physicians.



ASSIGNMENT:  In one single spaced typed paper 1.  identify the challenges you face and 2. referring to the Brookings article describe in detail how you would address the challenges to bring the group around to accept your proposal to join the ACO.

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