In ACOs (Accountable Care Organization), there are multiple ways of managing cost at the same time as holding the hospital (or other care center) responsible ('accountable') for quality. Though ACO is often discussed in opposition to FFS (Fee For Service), FFS is one of many strategies that an ACO uses, in addition to capitation placing caps on payments), incentives (for meeting benchmarks), and fees (for not meeting benchmarks). It is all very complex (= I'm not sure of all the details).
- you're asking if ACOs will last a long time. They are a current trend that CMS is pushing (with MU/MACRA) so there is a lot of incentive for hospitals to turn to ACO. Is it a short term trend (i.e. a fad)? in the 1970's and 80's, the concept of the HMO (Health Maintenance Organization) was created. It did well for a short period then lapsed in the 90's. And there are supposedly a lot of similarities between HMOs and ACOs. I suspect that ACOs will last at least as long as HMOs did, and probably longer (till the next accounting system idea comes along).
- Will there be a big push towards reimbursement for screening? There already is. It is a well recognized fact that screening (and prevention) saves health care dollars. And many such screening procedures have had reimbursement established (BP for HTN, yearly blood test for so many things, colonoscopies, mammograms, prostate exams, etc) and secondary screenings (e.g. a patient had a polyp so a higher frequency of screening colonoscopies are scheduled). So the trend here is definitely towards making screening more available and so reimbursement process is made easier.
There is some newsworthy questioning of too much screening: unnecessary reaction to positive results which may be false (mammo fears -> mastectomy, high PSA-> unneeded prostate surgery), bad business practices (Theranos scandal). The second is irrelevant, but the first is science which will determine better what kind of screening should and shouldn't be encouraged (by reimbursement).