Healthcare News & Insights

ACOs moving full speed ahead

Looks like the Medicare Shared Savings Program, which offers financial incentives for hospitals, physicians and other healthcare providers to team up in Accountable Care Organizations  (ACOs), is starting to pick up speed.

Recently, 27 ACOs have entered into agreements with the Centers for Medicare & Medicaid Services (CMS), bringing the current total  to 65. The number of beneficiaries receiving care from providers participating in the program has grown to more than 1.1 million.

And CMS is currently reviewing more than 150 applications from ACOs looking to participate in the program in July.

So far, CMS has established 33 strict quality measures ACOs have to follow in order to provide appropriate, safe and timely care. These quality measures relate to:

  • care coordination and patient safety
  • appropriate use of preventive health services
  • improved care for at-risk populations, and
  • patient and caregiver experience of care.

Advocates of ACOs see them as a way to improve care to Medicare beneficiaries, while at the same time slowing the rising costs of healthcare by changing the incentives that influence how hospitals and physicians work.

As for patients, ACOs are designed to improve care, reduce costs and lift the frustration of disconnected care (i.e., lost medical charts among multiple providers, sharing the same info over and over again among different doctors, duplicate medical tests and procedures, etc.).

Initially, hospitals were expected to dominate ACOs. However, the majority of the 27 new ACOs are physician-led organizations.

So why aren’t more hospitals jumping on the ACO bandwagon?

It could be because starting an ACO isn’t something you can do over a lunch meeting. It’s a complex, expensive and time-consuming project that requires dedicated and skilled leadership.

Maybe other facilities are waiting to see whether the first ACOs can operate successfully.

More than likely, it’s a combination of both.

Industry experts believe even if the Affordable Care Act (ACA) is shot down, since the Medicare ACO program isn’t the controversial part of the law, it will be able to stand on its own. If it can’t stand on its own, CMS may turn the program into a demonstration project.

The point is, many experts believe ACOs are the model to be followed for the future whether the ACA gets the Supreme Court’s approval or not.

What’s your opinion? Are ACOs a viable solution to help facilities lower healthcare costs and increase quality of care? Share your opinion in the comments box below.

For more information on ACOs, click here.




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