Will New Model of Accountable Care Organizations Cut Costs?
By - There are a variety of policy changes and healthcare reforms that have taken place since the Patient Protection and Affordable Care Act was passed in 2010. The development of Accountable Care Organizations (ACOs) is one such reform. With the help of Accountable Care Organizations, physicians, nurses, and other medical specialists are now able to better coordinate care across multiple healthcare settings.
One establishment that’s brought greater awareness and progress for ACO development is the National Association of Accountable Care Organizations (NAACOS). This coalition further helps develop public policy issues surrounding ACOs as well as offer greater education on best practices that promote coordinated care, according to a press release from RowdMap.
The company RowdMap is currently using government benchmark data to help multiple medical facilities and healthcare providers successfully transition to an accountable care system and become part of a shared risk model. Additionally, RowdMap works with industry coalitions to strengthen the greater compilation of individual organizations.
Currently, RowdMap announced partnering with NAACOS. The company will help this coalition meet their goals of policy evaluation, education, and government benchmarking data.
“We help ACOs use the new public benchmark data to make informed decisions about whether to choose in a traditional ACO, a next-generation ACO, or enter into a Virtual ACO with a payer partner,” Ashley Distler, Senior Client Strategist at RowdMap, Inc., stated in the press release.
With the US healthcare costs reaching $850 billion last year and focusing on more risky, complicated treatments, it is high time that the country switch to a more coordinated form of care based on value.
With as many as 42 percent of patients receiving care based on a fee-for-service payment model, too many hospitals are focusing on conducting more tests and high-intensity treatments in order to be reimbursed at higher levels. As such, pay for performance payment models and the creation of Accountable Care Organizations can provide a more cost-effective solution for health insurers.
The Centers for Medicare & Medicaid Services (CMS) have already established avenues to move away from fee-for-service models and embrace value-based care and the progression of Accountable Care Organizations. In fact, CMS has recently unveiled a Next Generation ACO Model.
Progressing from the Pioneer ACO Model and embracing the Medicare Shared Savings Program, the Next Generation ACO Model offers more direct financial targets for providers to reach as well as create a greater chance for medical facilities to coordinate care. In particular, it will be used among entire populations of patients. Providers will also be able to take part in higher levels of financial risk.
It is hoped that this new model of accountable care will bring about better health outcomes and lower costs among Medicare beneficiaries. With more financial incentives, patient engagement, and care management protocols, it is expected the Next Generation ACO Model will lead to higher quality care and lower expenditures.
“Included in the Next Generation ACO Model are strong patient protections to ensure that patients have access to and receive high-quality care,” CMS reported. “Like other Medicare ACO initiatives, this Model will be evaluated on its ability to deliver better care for individuals, better health for populations, and lower growth in expenditures.”
“This is in accordance with the Department of Health and Human Services’ ‘Better, Smarter, Healthier’ approach to improving our nation’s health care and setting clear, measurable goals and a timeline to move the Medicare program – and the health care system at large – toward paying providers based on the quality rather than the quantity of care they provide to patients. In addition, CMS will publicly report the performance of the Next Generation Pioneer ACOs on quality metrics, including patient experience ratings, on its website.”
