The regulatory definition of an ACO is actually defined in PPACA (Obamacare), but the general idea is a good one.  The "A" stands for accountable, which means the providers are held accountable by a 3rd party, i.e. the insurer.  The NYT columnist reached the complete opposite conclusion compared to the reality.  There will be a greater need for quality analysis and financial metrics (both our job) with ACO's, not less.  Even in a totally unregulated, free market situation, there will always be an insurance element to health care delivery.  Whether the insurer will be private or government administered is another story.

I'm in the health insurance game and we're all about about ACO's.  We came up with the idea.  The NYT columnist isn't alone in being a person who kinda/sorta knows what an ACO is, then fills in the blanks with what they'd like it to be.

My favorite part of the article is the ridiculous non-sequitor: "Today, consumers have to choose among insurance plans with a bewildering array of copayments, deductibles and annual out of pocket maximums.  In the A.C.O. model, consumers will choose a primary care physician."  Who doesn't choose their physician?  And what does that have to do with paying him?

That's like saying "chefs are presented with a bewildering array of ingredients and recipes, but their confusion will soon be over!  Behold, we've remodeled the kitchen!"

They're way behind noticing this trend.  My friends and I have been calling Victoria's Secret the "Sweatpants Boutique" for years.

No kidding.  By the NYT's account you'd think Andy Kaufmann, or Hunter Thompson just died.

The headline should read: “Obama’s best hope for a single payer system is for the Supreme Court to strike down the individual mandate.”  The individual mandate portion of PPACA was going to be the only thing keeping the private insurance market profitable with the hundreds of other nickel and dime rules in Obamacare.  People seem to think Obamacare and the individual mandate are interchangeable synonyms.  I can assure you that they are not.  Most states are either way behind, or not even trying to set up their insurance exchanges by the 2014 deadline.  Not meeting the minimum guidelines in PPACA, HHS will by law seize control over the states’ exchanges.  Since the law is rigged to make the private insurance market impossible to operate in without the individual mandate, insurers will bow out creating a crisis that forces the government to swoop in and administer the nation’s healthcare benefits.  Talk to anyone in administration in the insurance business.  This is the game plan, and we’re all prepping our resumes to submit to HHS.

[Edited]