Accountable Care Organizations are groups of doctors, hospitals, and other healthcare providers voluntarily agreeing to take on financial risk and share savings with Medicare. These programs are intended to improve quality and reduce costs.
They encourage providers to coordinate patient care, promote better health education, and improve self-management support for patients with chronic illnesses.
Coordination of Care
ACOs take value-based reimbursement to the next level by tying payments to quality and allowing providers to share in cost savings. This model encourages care coordination and improves outcomes through a shared financial incentive between payers, doctors, hospitals and other healthcare service providers.
Care coordination refers to the real-time communication of relevant health information between healthcare professionals. It is the foundation for a well-coordinated healthcare system and, as such, plays a vital role in advancing quality improvement goals related to better management of chronic disease, reduced medical errors, and lower costs.
In addition, accountable care organizations (ACOs) aim to reduce fragmented care that leads to unnecessary spendings, such as repeated lab tests or doctor trips, when a simple phone call could resolve the issue. ACOs that have taken on greater levels of financial risk—incentive and shared savings—have shown greater success in reducing costs. Moreover, successful ACOs focus on the patient’s care experience and develop a network of high-quality, low-cost providers for patients to visit.
Patient & Family Engagement
Patient and family engagement is a patient-centered approach to care that has been shown to improve outcomes and satisfaction while lowering costs.
Engaging patients and families is a way to ensure they receive consistent information from the medical team about their condition and promote adherence to treatment plans. It is also a way to improve communication between staff members.
Moving up the engagement continuum, clinicians and health systems offer timely, complete and understandable information; elicit patients’ values, beliefs, and risk tolerance regarding care choices; give them access to and help create their medical records; and encourage and support patient participation in care.
At the higher end of the continuum, patients are active partners in defining agendas and decisions and share power and decision-making responsibility. They communicate with clinicians through daily huddles and patient-family meetings, use nurses’ bedside change-of-shift reports to keep patients informed and conduct interviewing sessions in the waiting room.
Preventive Care
Getting recommended preventive care helps the population health, avoid disease, live longer, and save money. Unfortunately, many families face financial barriers that prevent them from receiving the vital services they need. Even those with insurance may be deterred by high copayments and deductibles that make it difficult to afford the cancer screenings, immunizations and well-baby visits they want for their children.
Accountable Care Organizations offer a potential solution. They can incentivize hospitals, physicians, post-acute care providers and other healthcare providers to form partnerships to coordinate care delivery and improve outcomes. They can also encourage them to reduce costs by negotiating bundled payments. These contracts reward providers for lowering overall costs and meeting quality metrics.
As the healthcare field shifts from volume to value, stakeholders pilot different value-based payment models. Some allow ACOs to receive shared savings if they meet cost benchmarks while demonstrating improved outcomes.
Patient Safety
Escalating costs in health care has brought increased attention to the need for quality improvement. Patient safety is a top priority of medical professionals and has become the focus of a global movement with its day.
Patients must be informed about safe practices to minimize health risks from preventable errors such as harmful prescription drug interactions between different doctors. Healthcare organizations must implement procedures that help them keep track of medications and other treatment plans.
Accountable Care Organizations can also improve patient safety by implementing policies encouraging employees to report errors or near-misses in a way that feels comfortable for all stakeholders. Leadership at all healthcare organization levels is needed to make these procedures well-known and easily accessible to staff. This will decrease feelings of intimidation that can keep people from reporting issues. It’s essential to promote a culture of patient safety supported by every healthcare team member, including administrative and frontline staff and contract workers.
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