Accountable Care Organizations (ACOs) Explained

The Issue

Currently th U.S. is responsible for consuming 55% of the world’s healthcare dollars. Around 45% of that is being spent in hospitals and 25% is going directly to the physicians. If we continue this way and do not change our processes, by 2017 we will be responsible for 75% of the world’s healthcare spending. Excuse us, but we’re going to agree that we are in dire need of some serious health care reform. The government has proposed a number of healthcare changes that would work to achieve the goal of lowering spending to get the U.S. out of debt, but what is the most talked about resolution? Accountable Care Organizations.

So, what is an ACO really?

- A joint venture of providers that network to share responsibility of providing care to patients

- Combined: Leadership, decision making and payment

- Promotes improved quality of care for Medicare patients and lowered costs

- Physicians are rewarded for maintaining wellness for patients, rather than for services rendered

More Details

“Care Core”

The core leader of an ACO is important because the level of success that leader has had in the past can be indicative of the venture’s overall success. One might think that the logical “Care Core” would be a large hospital, however most believe the “Care Core” should be Primary Care Physicians.  This advanced style of physician integration is easier for larger facilities, but does not aim to disclude smaller practices. The Senate even states that an ACO can be built and successful without hospitals altogether.

What Will ACOs Mean for Healthcare?

- Full integration into the industry for those providers involved

- Lowered healthcare costs, movinh away from fee-for-service model

- An aligned payment system for patients and providers

- Improved quality of care 

- Lessened concern for the commoditization of imaging facilities

- Decreased over-utilization

- Focus on patient wellness and prevention of illness