In today’s era of value-based healthcare, Accountable Care Organizations (ACOs) are right at home as they strive to provide quality, efficiency, and healthy outcomes for patients.
According to the Centers for Medicare & Medicaid Services (CMS), ACOs include networks of doctors, hospitals, and other health care providers who come together voluntarily to provide coordinated high-quality care to their Medicare patients. The goal of this coordinated care is to ensure that patients, especially the chronically ill, get the right care at the right time, while avoiding unnecessary duplication of services, medical errors, and hospitalizations. It’s about preventing episodes before they occur.
Value-based care will soon replace a majority of fee-for-service payment models, which rewarded doctors and hospitals for each service they performed, and prompted more tests and procedures. This model has been associated with higher costs and the impact on quality improvement is uncertain. ACOs, on the other hand, work in a value-based care model, creating savings and incentives by offering bonuses when providers minimize costs and meet specific benchmarks focused on prevention and managing chronic disease. This model helps healthcare providers succeed, but, ultimately, the patient is the winner because the goal is to keep them healthy.
It’s important to note that achieving success is challenging, and some ACOs have been unable to meet their goals. However, if your practice is up for the challenge, here are 5 reasons your practice might consider joining an ACO:
- Savings. With an ACO, healthcare providers are incentivized to keep patients healthy, avoid unnecessary procedures, and keep patients out of the hospital through preventative care. ACOs saved Medicare $713 million in 2016. When an ACO is successful, everyone gains by improved care delivery, improved health outcomes, and lower healthcare costs.
- Quality. CMS has established quality care measures for ACOs that are related to at-risk population, diabetes, hypertension, and more. These quality standards not only determine the savings that healthcare providers receive, but also result in prevention and better care of patients thanks to the attention paid to them.
- Partnerships. An important goal of the ACO is to work with other healthcare providers. Accountability, tools, resources, risk, and referrals are all shared. Providers can be more strategic in tracking patient care. Or, if a physician needs assistance on a particular condition or injury, he/she may collaborate on treatment strategies with other doctors in the ACO.
- Control. Many ACOs are physician-led. They allow providers to feel empowered to administer the care patients need, and tests and procedures may be ordered as precautionary that may be considered excessive or even unnecessary. Physicians don’t feel they have to prescribe treatment plans for patients based solely on insurance benefits.
- Modernization. Being proactive in providing patient care involves sharing data between doctors, which means healthcare providers need the right technology in place. On their own, it can be hard for smaller practices to afford and implement point-of-care technology. Having shared access to technology through an ACO is a big bonus. With accessible data, organizations can track compliance, share treatments, and meet performance standards.
Ultimately, coordinated care is good for patients—especially with a cost-effective, quality-based outcome model like the ACO. For more information on the CMS Shared Savings program, visit their website. If you want to know more about how services from Quest Diagnostics can support ACOs, contact us at 1.888.491.7900.