An excellent baseball-playoff themed edition of the Health Wonk Review is at Wing of Zock, hosted by Jennifer Salopek – be sure to head over and check it out. This article by Jason Shafrin should be of interest to anyone who has been paying attention to all the talk about ACOs lately. I have been generally impressed with what I’ve read regarding the potential cost savings and improved efficiency that ACOs will hopefully provide. However, although health care reform has focused quite a bit of energy on the creation of ACOs, it is far too early to tell whether they will be successful or not. Jason’s article analyzes a RWJF report that found generally negative results when hospitals in a particular area were highly concentrated or merged. And he notes that the findings with regards to hospital mergers and concentration could indicate that ACOs might actually increase costs rather than control them. There are differences between ACOs and traditional hospital mergers, but Jason’s point is definitely worth considering. Although some ACO-style arrangements are showing some success (and some are already in place here in Colorado), we can’t assume that the ACO model will be an automatic path to cost savings. Without very careful management, it could end up having the opposite effect and also lead to decreases in the quality of care.