Accountable Care Organization
Accountable Care Organization (ACOs
In 2013, Health Information Exchanges are growing in number, the Meaningful Use initiatives within healthcare organizations are moving forward, and numerous healthcare facilities are considering forming or joining Accountable Care Organizations in their region. The management of health data and information is foundational to all of these initiatives and others. Select one of these current initiatives (you may select one mentioned above or another) and discuss its importance to the future of healthcare.
1. Describe how this initiative supports patient quality care.
2. Discuss whether it will help decrease healthcare costs.
3. Explain how health informatics is critical to the initiative.
4. Discuss whether this initiative will impact patient access to care.
Complete a 2- to 4-page response using Microsoft Word using Times New Roman or a similar font, 12 point, double spaced. Select 2-3 current articles from journals to support your responses.
Health and Social Care Essay.
Accountable Care Organization (ACOs
An Accountable Care Organization (ACOs) is a consensual group of doctors, hospital and other medical care providers who have come together to provide high-quality health care to their patients by coordinating. The objective is to enable patients, especially the chronically ill, access the correct, timely and comprehensive care. ACOs also help reduce duplication of services or medical errors. The problem with most health systems today is that patients get each part of their healthcare from different providers. ACOs were included in the law passed by the Congress, the Medicare Shared Savings Program. In it, health service providers are held jointly responsible for a patient’s health. In return they get additional INCENTIVES to cooperate and save money by streamlining the service delivery (Eichenwald, LaTour, Oachs & American Health Information Management Association., 2010).
Concurrently, the Centers for Medicare & Medicaid Services (CMS) implemented another strategy, called the Pioneer Program, targeting high-performing health service providers to take home more of the projected savings in exchange for assuming the bigger financial risk.
In 2014, the top 20 ACOs that formed the Medicare Pioneer Program and the 333 in the Medicare Shared Savings generated a total of $411 million in savings even though after paying bonuses, the program closed the year with a net loss of $2.6 million. The program is expected to be expanded with the Human Service Secretary aiming at tying 50 percent if all Medicare payments through innovative payment methods like ACOs (Eichenwald, LaTour, Oachs & American Health Information Management Association., 2010)
Doctors and hospitals will increasingly refer patients to hospitals and specialists within an ACO network. Patients, however, are free to see health providers they want outside the system at no extra cost. Providers in an ACO network are required to inform their patients, who may choose to remain or seek another doctor if they are uncomfortable with being part of the system. The patient has a right to refuse their data shared within the ACO. ACOs are typically made up of hospitals, specialists, post-acute providers and even private companies. The single prerequisite element is a primary care physician, who acts as the driver of the program (Healey & Marchese, 2012).
Health Informatics refers to the acquisition, storage, retrieval and use of healthcare information to facilitate better coordination amongst a patient’s several healthcare components. Health Informatics occupies a crucial role in the implementation of healthcare reform. Health Informatics is a dynamic specialization connecting information technology, correspondence, and health care to revolutionize the quality and safety patients receive. Health informatics uses informatics concepts, theories, and past real-life situations to predict and effect better health care choices. This process mostly involves the collection, storage, analysis, and presentation of data in a digital format (Healey & Marchese, 2012). Health Care Informatics not only links ACOs, but it also enables all the health specialist to monitor the patient’s progress and history even from other medical service providers.
ACOs have already endeared themselves to American who are joining them in droves. However, they are deemed to be just a provisional measure on the path to an efficient American health care system (Eichenwald, LaTour, Oachs & American Health Information Management Association., 2010). One of the biggest problems facing hospitals and physicians is that the incentives in ACOs are to minimize hospital stays, emergency room visits and costly specialist and testing procedures— the biggest earners for hospitals and doctors in the fee-for-service arrangement. The eventual goal would be for health providers to assume full financial responsibility to care for a certain number of patients in return for a fixed payment. However, such an arrangement will necessitate movement beyond ACOs.
Eichenwald, S., LaTour, K., Oachs, P., & American Health Information Management Association.,. (2010). Health Information Management: Concepts, Principles, and Practice, Fourth Edition (1st ed., pp. 218-220). AHIMA.
Healey, B. & Marchese, M. (2012). Foundations of health care management (1st ed., p. 89). San Francisco: Jossey-Bass.