Nearly nine of 10 leaders in healthcare and health care policy think that the lack of incentives and current financial interests of providers and other stakeholders are barriers to moving health care toward more integrated and accountable delivery models, according to a Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey, published today.

In the survey, leaders were asked their views on barriers to delivery system innovation and strategies for fostering more accountability and coordination among health care providers. The findings were summarized in a news release issued by the organization.

Healthcare leaders pointed out obstacles to the growth of Accountable Care Organizations (ACOs), but were also quick to identify potential solutions. Large majorities support providing special payment arrangement to ACOs (65%) and giving providers financial incentives to practice in ACOs (65%)—similar to provisions in the Patient Protection and Affordable Care Act signed into law by President Barack Obama earlier this year.

Majorities of leaders support the growth of more integrated models of care delivery, like ACOs and integrated delivery systems, but also voiced concerns. Nearly three-quarters (74%) of opinion leaders said they were concerned or very concerned with providers acquiring excessive market power and dominance. To safeguard against such undue market share, a majority of healthcare leaders (56%) support regulation of ACO payment rates in regions with insufficient market competition—similar to the way a public utility is regulated. To alleviate concerns that accountable models of care would encourage providers to withhold appropriate care, more than eight of 10 leaders support the development of performance metrics for ACOs, as well as increased transparency and public reporting on quality of care, resource use, and costs.