Under ACOs, Small Medical Groups Must Join or Die

The Wall Street Journal—June 27, 2011

In response to your June 20 editorial "The Accountable Care Fiasco":

As policy makers seek to improve health-care quality and efficiency, they should examine and emulate those models of health-care delivery in this country that work. These models achieve excellent results for patients while reducing long-term costs by getting it right the first time, thus minimizing readmissions through the ER due to infections, complications and revisions from failed procedures.

Readmissions are far more costly than initial procedures and burden Medicare with many billions of dollars per year. Our hospital's exclusive focus on specialization in orthopedics and rheumatology, coupled with a strong institutional culture of excellence, enables us to achieve better results, create better value for our patients, and prosper even during challenging economic times. When all processes and people are focused on a specific set of priorities, an unmatchable level of expertise can be achieved.

Louis A. Shapiro

President and CEO

Hospital for Special Surgery

New York

Read the Letter to the Editor at wsj.com.