Guest post by Ron Vatalaro, who works at Bisk Education with the University of South Florida Morsani College of Medicine. He writes about health informatics.
The Affordable Care Act supports healthcare providers in reducing costs and improving efficiency while delivering quality care. Accountable care organizations (ACOs) achieve these goals by enabling physicians, hospitals and other healthcare providers to create networks and share responsibility to deliver care to Medicare and other patients.
At the heart of the ACO model are three core principles:
- ACOs are provider-led organizations with a strong primary care base, and collective responsibility for quality and per capita costs.
- ACO payments are linked to improvements in quality that also reduce costs.
- Performance measures that support improvement are sophisticated and reliable, and demonstrate that savings are achieved through improvements in care.
Joining an ACO is voluntary, but the federal government encourages participation to reduce unnecessary or duplicated services, prevent errors and keep patients healthier. When providers successfully coordinate services to meet a long list of quality measures, they become eligible for bonuses.
The Current Environmment
Medicare offers several ACO programs, including the Medicare Shared Savings Program, the Advance Payment ACO Model and the Pioneer ACO Model, but many other public and private models exist. Some are sponsored by physicians groups, while nonprofit organizations, hospital systems and health insurers sponsor others. The Pioneer Model was designed for early adopters of coordinated care, and is no longer accepting new members.
To date, more than 600 public and private ACOs have formed; in 2012, the first year of the program, they generated $87.6 million in gross savings. Government support is spurring considerable growth, and ACOs could well become the dominant model in healthcare.