If you are a healthcare professional, you have likely heard of “accountable care organizations” or “ACOs.” If not, here are the basics of this key piece of the healthcare legislation.
Today, most hospitals and doctors work independently, which some claim can drive up costs and compromise quality. ACOs were conceived to promote coordination and cooperation among providers with the intention of boosting the quality of care for Medicare beneficiaries and cutting costs.
It works like this: Your organization is paid to cover the cost of care for Medicare beneficiaries in a given area, and if you are able to meet quality and cost-saving targets, you earn financial rewards for doing so. It’s an idea that grew out of research conducted by Dr. Elliot Fisher as part of his Dartmouth Atlas Project, a 30-year investigation into the variations in care across the country.
A few healthcare systems around the country are already exploring the possible benefits of ACOs, including two competing hospitals in Omaha, Nebr., and a large hospital system and health insurer in Louisville, Ky.
While shared savings programs and ACOs for Medicare and Medicaid beneficiaries are an important parts of the new health reform law, antikickback laws, antitrust laws, and other federal rules are proving a challenge as government agencies seek to write the rules for ACOs.
The legislation calls for ACOs to roll out by January 1, 2012. To learn more about ACOs and which organizations are eligible, check out the Q&A from the Centers for Medicare & Medicaid Services (CMS).
Till next time,