Accountable Care Organizations:
As I have blogged in the past, I am not a big fan of our healthcare system in America. I think I have come across something that is a vast improvement to what we are doing now. It is called an Accountable Care Organization. Here is how it works.
Accountable Care Organizations seek to create a healthcare system where people, even though they are living longer, are healthier than ever before, the quality of care is continually improving, and the cost of care is affordable for all Americans. In this system healthcare providers across the country from primary care doctors and specialists to hospitals and large health systems are all collaborating and coordinating care with each other to improve outcomes for their patients and getting paid well in return.
Under an Affordable Care Act program $126 million in bonuses were issued nationally last year by the Center for Medicare and Medicaid Services. Twenty-nine groups of doctors across the country have received bonuses for lowering costs to taxpayers while keeping patients happy. The government tracks Medicare spending for certain patients and if it goes down compared with past years, and the care meets standards of quality and patient satisfaction, the doctor groups share in the savings.
Slightly fewer than 1/2 of accountable care units formed in 2012 managed any savings after a year, but 1/4 achieved significant savings. Here in Florida Palm Beach Accountable Care Organization and Accountable Care Options in Boynton Beach say they have saved taxpayers $30 million combined last year. They received half the savings as a bonus ($15 million).
ACO's are currently serving about 4 million of the 50 million Medicare beneficiaries. Dr. Francisco Perez-Mesa, a doctor with a Boynton Beach ACO says, "Its a total change in approach. The primary care physician is rewarded for looking past the patient's immediate issue and aggressively addressing all of the patient's chronic conditions. This combined with early screenings, prevention, and education can result in significant savings to Medicare and performance bonuses to the physicians." It can work, though it often means providing a lot more attention to patients at the primary care level to head off more expensive care such as a hospital stay. The ACO is going to do everything it can at the primary level. A fundamental problem with the traditional fee-for-service system is that doctors , other health professionals, and hospitals often have little incentive to work together to avoid repeat hospitalizations and tests or to coordinate treatments and prescriptions. The ACO goes out of its way to coordinate and communicate so as to avoid expensive duplication.
Not everyone believes it can work on a large scale, and statistics suggest it is not easy to pull off. ACO's must invest a lot of money setting up for this system. They may find themselves on the hook for patients who don't comply with recommended treatments or lifestyle changes.
I agree with Centers for Medicare and Medicaid Services spokesman Alper Ozinal who states, "These ACO's are showing promising initial results and are providing insights as to how to improve and reform our country's healthcare system.
What do you think?
