ACA Promotes Use of Accountable Care Organizations

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The Affordable Care Act is looking to keep healthcare costs down in 2014 and beyond. Specifically, it is looking at how physicians and hospitals do business. One approach that seems attractive to the federal government is the development and use of Accountable Care Organizations (ACOs).

Accountable Care Organizations (ACOs)

The Centers for Medicare & Medicaid Services (CMS) defines ACOs as “groups of doctors, hospitals, and other healthcare providers, who come together voluntarily to give coordinated high quality care to their Medicare patients. The Health and Human Secretary (HHS) website describes it as “smarter care.” 

According to the HHS, health reform focuses on driving a smarter healthcare system focused on the quality, not quantity, of care.  More than 360 organizations are participating in one of Medicare’s Accountable Care Organization programs across the country, which encourage quality and care coordination through the use of health information technology. Together, these initiatives are improving primary care for nearly 5.3 million people with Medicare and are expected to save up to $940 million in the first four years.

If successful, physicians and hospitals may be eligible for a bonus from Medicare. And private health plans are considering similar models as well. Because of these incentives to team up, we may start to see a shift where hospitals look to scoop up smaller local practices with primary care doctors, who treat everyone ranging in age from 9 to 95.

If the practice you visit, or specifically your doctor, joins an ACO you may or may not notice some changes. You will likely still go to the same location for a patient visit and see the same familiar faces. You may even benefit from some improvements, likes free access to a lifestyle coach or nutritionist.

Due to the ACA’s support of emerging models of care delivery means, changes occurring within the doctor and hospital setting can be expected.  The ability to share medical records electronically, reduce billing across multiple facilities, and effectively manage the full spectrum of an individual’s healthcare needs will ultimately not only incur savings, but also improve the quality of care delivered.

 

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