Aco Review and Discussion

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Accountable Care Organization

There is a growing need in our current healthcare society for controlling costs and quality of healthcare services. Clearly this need for "middle-ground" options or payment reforms are desired in order to provide greater flexibility and accountability for the costs and quality of care than typical pay-for-performance, shared savings, and medical home programs, but which avoid forcing providers, particularly small physician practices, to take on more financial risk than they can manage or to take accountability for services they cannot effectively control. “In light of the high and rapidly growing cost of healthcare in the U.S., there has been growing interest both in the federal government and in states and regions across the country in finding ways to encourage health care providers to take greater accountability for the overall cost as well as the quality of healthcare delivered to patients. A healthcare provider or group of providers that accepts accountability for the total cost of care received by a population of patients has been termed an “Accountable Care Organization”’ (http://www.chqpr.org/) Like Clinical Integration’s efforts to improve patient care throuhgout the healthcare community, (ACO) Accountable Care Organizations are also a type of payment and delivery reform that seek to “tie provider reimbursements to quality metrics and reductions in the total cost of care for an assigned population of patients” (Wikipedia). Ultimately they seek to provide quality and efficiency in the delivery of healthcare services amongst patients and third party payors. There are many types of payment reform models, one in particular that has been adopted by the Government and developed by the centers of Medicare and Medicaid is the “Shared Savings Program.” “Section 3022 of the Affordable Care Act requires the Centers for Medicare & Medicaid Services (CMS) to establish a shared savings program to facilitate coordination and...
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