The Role of ACO Healthcare and What It Is All About,,,,,

Governmental payers, commercial health insurance providers and the employer community are all pushing for an integrated healthcare delivery system where hospitals and physicians are held accountable for the quality and cost of healthcare. regardless of the success aco healthcare, healthcare providers will need to engage in a system that encourages quality measurement reporting, care coordination and more communication. at the center of the aco is a group of empowered primary care physicians who are equipped with the data, leadership and resources to manage and coordinate care for patients throughout the entire community.

The Most Important Aspects

Considered family physicians are the primary care providers and thus they are the most important within the aco development. growth of acos signals that the healthcare system is moving apart from the existing fee-for - service models that has been relied upon for making payment. whether you are a participant in the aco or not, it is clear that, the current environment of payment will move away from the pure ffs ( fee-for - service ), towards a formula that promotes efficiency and value for patients. in other words the community is moving towards the system that seeks to pay for value as opposed to paying for volume.

Family physicians should be concerned about acos. the physicians should seek to implement a pcmh ( patient - centered medical home ) roomates involves the use of patients registries, care coordination, health information technology and care team. these capabilities are borne to be rewarded by the new payment environment that features enhanced incentives and payments.

Structure And Payment In an ACO

The ACO is a conceptual model of the framework that seeks to improve the quality and efficiency of healthcare through financial and clinical integration. the framework is taking different forms that seek to meet the local market conditions as well as the existing competition that is evident among healthcare providers. nevertheless, the aco will fail over the long - term unless the framework is able to minimize fragmentation of care, and waste variability.

ACO receives payment for the services by the patient population that it serves. incentives and payments within the framework should be structured in such a way that it fosters a shared responsibility for quality and cost. this offers the opportunity for higher earning potentials among the physicians providing care. the payment models features a fee-for - service component, performance incentives and a care - management fee. to attain the desired results it is important to balance out these 3 components with 50 % fee-for - service, 30 % and 20 % performance incentives care - management fee.

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