Accountable Care Organizations (ACO)
The accountable care organizations (ACO) are healthcare organizations characterized by a payment and care delivery model that seeks to tie provider reimbursements to quality metrics and reductions in the total cost of care for an assigned population of patients.
Presenter Partners Healthcare Network – Dr. Chaqutunu
There are 18.2 million lives that are covered by accountable care organizations (ACO’s) in the US. Any medical condition that has a mental health component is 42% more costly. If medical assistants and physicians work in the same physical general area, there is a much better information flow of medical information. ACO’s differ from HMO’s on the gatekeeper concept. Instead of having a Dr. be the HMO gatekeeper, access to enhanced medical treatment and providers is very important.
ACO’s also provide referral feedback to the primary care physician from the specialist. ACO’s also provide access to more acute or emergency care when needed. The explanation/assessment of the risk for a certain procedure is more defined to a patent than just the general risks. (30 year old vs. 80 year old patient). Personalized consent forms are crucial in this situation.
The return on investment (ROI) cannot be measured unless the numbers are studied for a large population. Physician incentives are very important with transforming the delivery of treatment to patients. Fitting ACO’s into the Workers Comp arena will be complicated.
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