Having an ACO that doesn't care about changes in patient behavior is not going to succeed.
While the 'change in physician behavior' aspect will cause some issues as well, I believe that people generally over-consult (especially in the hospital) for relatively minor issues.
I love the suggestions of the author at the end. Minute clinics run by a NP to save money. Everyone cites the same garbage studies about how NPs have equal outcomes and better satisfaction. Specter, if you read this, could you copy and paste one of your detailed breakdowns of the NP = MD article and consider submitting it for publication in some news source like huffingtonpost, forbes, or wsj? Something that the layperson reads and not SDN.