Copy of Assignment 6 -- Group 2


Systems - Based Practice

Group 2: Meyers, Olson, Rahman, Shaw

 

Describe the intent and role of Accountable Care Organizations in health care provision.

     The Accountable Care Organization (ACO) is intended to streamline healthcare for Medicare patients. Specifically, the idea is that a network of physicians and hospitals which make up the ACO would be responsible for total care of the patient.  When the total care of the patient is managed under one "umbrella" such as the ACO, the thought is that high quality care can be provided in a more cost-effective way. The ACO would ideally allow the varied parts of a patient's care (PCP, Hospital, Specialists, Home Health, etc) work together more efficiently. Another motive behind the ACO idea is cost-savings. The current fee-for-service system that Medicare uses would be hybridized into a system which would potentially reward the members of the ACO for providing cost-effective care, preventive care and close management of chronic disease states.  Essentially, ACOs would be rewarded for keeping their patients out of the hospital.

     This sounds suspiciously similar to an HMO, but the main difference is the ability of the patient to obtain care outside of the ACO network.  Because of this flexibility, it becomes even more necessary for the ACO to make all of its diverse parts work together -- providing a good product such that the patient will not choose to seek care outside the network.

 

What are ACOs and how will they function?

     An Accountable Care Organization (ACO) is an organized network of physicians and hospitals committed to the provision of high-quality, low-cost care to Medicare patients. Currently the ACO is still conceptual. A reporter for NPR states, "ACOs have been compared to the  unicorn: Everyone seems to know what it looks like, but nobody's actually seen one. Exactly how ACOs would work in practice remains to be seen..." (Gold, J. http://www.npr.org/2011/01/18/132937232/accountable-care-organizations-explained). It is also not clear who will be running the ACO -- will it be hospitals? doctors? insurance companies? 

 

How do ACOs fit in with Consumer Driven care---are they different? In what way?

     Since patients will retain the option to seek their care outside of the ACO, the idea maintains some patient-centeredness. Of course, it is also possible that the patient will not be directly aware that they are being treated as part of an ACO.