:The Next generation of Healthcare in America|
Accountable Care Organizations and the National Healthcare System The Next Generation of Healthcare in America
National healthcare has been a hot button issue around dinner tables in America for years. Everyone seems to have an option on what will or will not work, how our county will afford it and what a plan would entail. Although we are unsure of how a plan would affect the country or the average American. Whether one is for or against the current healthcare plans that have been put in place by our government, We can all agree that the need for a national healthcare system is due to rising healthcare cost, the rapidly rising rate of uninsured American in our county and the rising cost of the average insured healthcare premiums through their employer based healthcare coverage plan. Accountable Care Organizations Could be part of the answer to the healthcare puzzle ACO’s offer a several befits to help to help curb spending and over utilization of healthcare by setting accountability, quality, and Healthcare standards. No one can argue that the United States of America has a grave need for some type of national healthcare system one reason for this is the rapidly rising cost of health care. The rising cost of healthcare is due to several factors. The main causes are technology, prescription drugs, chronic diseases, aging populations, and rising administrative cost. The cost of technology and prescription drugs has sky rocketed over the last several years. Analysts agree that the rising demand for the development of technology driven services and prescription drugs whether they are more effective than previous technologies and drugs or not has a large direct effect on the total healthcare cost. Consumers are demanding availability of these more expensive technologies and drugs as they are developed, even if they are not as cost effective as other services that are available. (United States Congress) Accountable Care Organizations Could help reduce some of the overall expenses of the current healthcare model. ACO’s are based on a quality metric system where payment delivery reform is tied to provider reimbursement quality. They do this by looking at the reduction of the total healthcare cost of a given population. ACO’s use a range of different reimbursement models like fee for service and captioned Payments, it is believe that because of this fee schedule providers will focus more on quality of care and less on amount of patients cared for. Providers are then held accountable to third party payer for their appropriateness, efficiency, and overall quality provided. Medicare states that an accountable Care Organization is, "an organization of health care providers that agrees to be accountable for the quality, cost, and overall care of Medicare beneficiaries who are enrolled in the traditional fee-for-service program who are assigned to it.” (Brookings Institution)
Chronic diseases and aging populations are also a large cause for the rising cost of healthcare. The nature of health care in the U.S. has changed dramatically over the past century with longer life spans and a greater presence of chronic illnesses. The new ageing population with chronic diseases has placed a tremendous demand on the health care system, particularly an increased need for treatment of ongoing illnesses and long-term care services such as nursing homes. Analysts have gathered that Aging population and People with chronic diseases makes up over 75% of the total healthcare cost In the United States (Centers for Disease control). Rising administrative cost is also affecting the average American healthcare cost. It is estimated that Medicare spends less than 2% on average of their total budget on administrative cost while the privately insured system spend an estimated 7% of healthcare spending on administrative...