Can someone explain Accountable Care Organization to me.
Ans) An Accountable Care Organization is a healthcare organization that ties provider reimbursements to quality metrics and reductions in the cost of care.
- ACOs in the United States are formed from a group of coordinated health-care practitioners. They use alternative payment models, normally, capitation.
- Goal:
Ensure that patients, especially the chronically ill, get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors.
- Outcome:
When an ACO succeeds both in delivering high-quality care and spending health care dollars more wisely, it will share in the savings it achieves for the Medicare program.
Payment models in an ACO:
-capitation
-bundled payment
-shared savings
ACO targets high risk patients:
-apply quality measures (many medication related)
-case management
-care coordination
Benefits of ACO:
- The benefits of ACOs are numerous and there are many stakeholders who obtain advantages from this model of care. The patient community gains a wide number of advantages including improved outcomes, better quality of care, greater engagement with providers, and an overall reduction in out-of-pocket costs.
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