ACO Implementation

Time Frame for Implementation Section 3022 of the Affordable Care Act (ACA) includes Section 1899, the Social Security Act. In this section, an addendum was created that there must be a formation of a Shared Savings Program. The Shared Savings Program is groundwork for the ACO (Department of Health and Human Services, 2011). The Shared Savings Program is part of the timeline for implementation of affordable healthcare in America (The United States House of Representatives, 2010). The United States House of Representatives penned an implementation time line to improve the healthcare environment and decrease overall healthcare expenditures. ACOs, which are part of the integrated healthcare system, were encouraged to be in place by 2012.
ACOs are expanding outside of the Medicare setting and private health insurance companies are considering or trialing the use to decrease expenditures. The overall hope is that ACOs will bring HCPs, hospitals, and the interdisciplinary team to work together to improve quality and decrease healthcare expenditures (Fischer & Shortell, 2010). To have an overall positive impact through use of ACOs, organizations will have to “encourage organizational capabilities necessary to meet program requirements” (Fischer & Shortell, 2010). HCPs will have to develop new relationships in the ACO, responsibilities for outcomes will increase, changing based upon mistakes and outcomes will need to be done quickly, and transfer of knowledge through communication will have to be done throughout the ACO (Fischer & Shortell,
The American Nurses Association (ANA) has called for all healthcare staff to be leaders when developing change related to ACOs as it is important to ensure “patient centered care” (American Nurses Association, 2010). Nurses will play a primary role, as care at the bedside must be taken into consideration in relation to outcomes and process changes. One challenge is that the healthcare hierarchy as traditionally placed physicians over nurses but it has been recognized that “nurses must have equitable leadership as physicians and other services” when changing to an ACO (Tillett, 2012). During the change to an ACO, nurse executives must step up in order to ensure that processes are changed in effort to meet outcomes. One primary importance with the change is that “nurse executives have significant experience in these types of health and quality promotion” changes (Tillett, 2012). Nurses can become leaders for all healthcare staff in driving change and ensuring patient care outcomes and needs are