Healthcare facility administrators and physicians report that the most serious obstacle they face in forming accountable care organizations (ACOs) is physician interest, according to a new survey.

The survey, conducted by AMN Healthcare, a healthcare staffing and workforce solutions organization, asked hospital executives and physicians about their participation in ACOs, and whether or not they think the model will deliver significant cost and quality benefits.

[See also: CMS extends application deadline for ACO pioneer project.]

Fifty-eight percent of 882 administrators and physicians responding to the survey indicated their facilities are either in the process of forming ACOs or are considering doing so, while 42 percent said their facilities will not form ACOs in the foreseeable future.

Of those who are moving toward ACOs, 42 percent said physician alignment is the most serious obstacle to their efforts, followed by:

• lack of capital (38 percent);

• lack of integrated IT systems (31 percent);

• and lack of evidence-based treatment protocol data (25 percent). 

The survey found that of those who are not moving toward ACOs, 40 percent cited physician alignment as a reason they are not, followed by:

• lack of capital (31 percent);

• lack of integrated IT systems (26 percent);

• and lack of evidence-based treatment protocol data (23 percent).

According to AMN Healthcare president and CEO Susan Salka, the survey underscores what is the central issue regarding both ACO formation and the industry-wide effort to enhance quality of care and reduce costs.

"While capital and data are essential to forming ACOs, the success of this emerging model turns on people," Salka said. "Health facility leaders and physicians must align their interests, communicate and cooperate for this model to work."

[See also: Q&A: Expert points to IT power of ACOs.]

The survey further suggests that the majority of healthcare facility administrators and physicians still hold out hope that ACOs will deliver significant cost and quality benefits over time. 

Fifty-nine percent of those surveyed either strongly agreed or somewhat agreed that ACOs will deliver benefits and that they are a key to enhancing quality and reducing costs. However, a significant minority (41 percent) either strongly disagreed or somewhat disagreed with that statement, the survey found.

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