Accountable Care organization ACO

Topics: Health care, Health economics, Managed care Pages: 8 (1717 words) Published: May 23, 2015


Accountable Care organization ACO & apos;s

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Background
Accountable care organization is composed of a group of care providers, hospitals, and doctors who join up collaboratively together to provide high-quality care to the patients. The goal of an Accountable Care Organization is to ensure that they provide coordinated care to the patients ensuring that the chronically ill especially will get the right care at the right time while avoiding unnecessary services duplication as well as preventing medical errors. The rate of healthcare spending is expected to rise by 6 percent every year by the end of 2020 in the United States (Devore & Champion, 2011). By the period, the health care spending is expected to account for about a fifth of the country economy and the federal government will be expected to pay a greater share in financing the health care cost ever than before. In the recent days, there have been reforms in the Medicare federal programs changing the way the healthcare is paid for and organized. Recent rules have stipulated a new path for hospitals, doctors and other healthcare providers to form teams referred to as “Accountable Care Organizations” that are essential in saving money through coordination of medical care services for the patients. Under the reforms, the teams are expected to provide health care at a lower cost treating the patients for lesser money. The government has committed to rewarding such organizations financially if they meet the expected quality measures (Lieberman & Bertko, 2011). Development

An Accountable Care Organization is a form of managed care that differs from the health maintenance organizations. They are normally run by doctors, a group of health care practitioners or hospitals rather than by the health insurance companies. In order to qualify for an Accountable Care Organization, the group, hospital or doctors must have an ability to provide primary care for at least 5000 patients or more (Devore & Champion, 2011). According to Greaney (2011) an Accountable Care Organization can be defined to be a set of health care providers that include specialist, primary care physicians and hospitals who work in Unisom to accept the collective accountability for quality and cost of care that is delivered to the patients. It can be developed around a variety of existing types of organizations. A number of multispecialty medical groups, integrated delivery systems, and physician hospital organizations are already functioning as Accountable Care Organizations or have their management structure evolved as that of an Accountable Care Organization. Other organizations providers such as the independent practice associations have transformed to Accountable Care Organizations while other are acquiring more infrastructure support in an effort of providing cost benefits and care as ACO’s. The Affordable and Care Act has the most significant contribution to the creation of Accountable Care Organizations through the traditional Medicare fee for service system. Through the platform, it allowed the Medicare to reward health care providers with a share of their savings resulting in enhancement of care quality as well as a reduction in the health care cost to their eligible Medicare populations resulting to the development of Accountable Care Organizations (McClellan, McKethan, Lewis, Roski, & Fisher, 2010). Health Impact

Accountable Care Organizations seek to tie health care provider reimbursements to the quality care provision, as well as a reduction in the total cost of care provision to the patients. The organization works with one or more players most commonly the Medicare in the attainment of a triple aim of enhancing the population health. It has a goal of enhancing the patient’s experiences during care delivery as well as reducing the cost of care delivery. A successful Accountable Care Organization needs to be composed of an empowered team of primary...
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