October 28, 2012 by astancilwomack
Since the Patient Protection and Affordable Health Care Act, commonly known as “Obamacare” was signed into law in 2009 there has been much talk about Accountable Care Organizations (ACOs), but what are these organizations?
These organizations are encouraged by healthcare reform law because the idea is to have a payment:service correlation, thus lowering the cost for patients who do not utilize the healthcare system often. The accountability is from the providers to the patients and the third-party reimbursement companies (i.e. insurance companies). The providers will be held accountable for their service provided, accurate documentation of said service, accurate billing, and overall efficiency.
Wikipedia defines the three core principles of ACOs well, ”
- Provider-led organizations with a strong base of primary care that are collectively accountable for quality and total per capita costs across the full continuum of care for a population of patients;
- Payments linked to quality improvements that also reduce overall costs; and,
- Reliable and progressively more sophisticated performance measurement, to support improvement and provide confidence that savings are achieved through improvements in care
These organizations are much more complex. I won’t go into the cost saving equations, or payment models. I just wanted to give more insight onto what these “ACOs” are. Please feel free to leave any specific questions, and I will answer them in the best way I can.