Accountable Care Organizations (ACOs) includes a group of healthcare professionals and health facilities that voluntarily come together to provide coordinated care to their Medicare patients. The importance of coordinated care cannot be overemphasized. It assists the chronically ill acquire accurate and timely care that caters to their diverse needs. In their roles, the team ensures that medical errors and unnecessary duplication of services are avoided. The ACO has played a critical role in the improvement of population health. Other than merely focusing on individual health, ACO emphasizes on the population health as well (Song, 2014). Through an initiative known as the population health management, ACO engages in prevention measures including the careful management of patients suffering from a wide array of chronic infections. Through the partnerships in the community, ACO seeks to impact individuals to remain in charge of their healthcare needs. ACO has shown its propensity towards the minimization of health disparities across the country. Health disparities occur in situations where inequality thrives. However, in mitigating this, the ACO has developed strategies to deal with members of diverse groups and populations, including the ones who have traditionally been neglected, such as persons living with disabilities and the immigrants (Song, 2014).
Smith (2011) pointed out that bundled care is not only service delivery but also a funding model. The model aims to guarantee increased integration in care delivery services and put a mechanism in place to enhance greater patient experiences and outcomes. In a bundled care approach, healthcare givers receive a single payment to cater to all the care needs of a patient with a wide array of issues. Thus, in a bundled care, the health providers or the facilities receive a bundled payment for all the services given in an episodic of care. An episode of care is defined as a host of healthcare interventions provided within a given period (Hardin, Kilian, & Murphy, 2017). However, this model of payment is associated with several risks that could carry far-reaching consequences. The providers can expose themselves to substantial financial risks depending on the level of compliance by the patient and the effectiveness of the services provided. In this model, payments are made based on the time period rather than the services are given. The bundled payments could also provide challenges to providers who are not used to working with their counterparts. As such, it could lead to corporation problems among the health professionals thus jeopardizing quality (Hardin et al., 2017).
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Today, many hospitals are complying with the government order requiring them to post the prices they charge for various services. As such, patients can view what they need to pay before engaging in care services. The benefits of showing pricing for care cannot be underestimated. First, it encourages a culture of transparency. After the patient has been billed, they can compare what they have been charged vis-à-vis what has been displayed in the payment catalog. Secondly, it provides the patient with the opportunity to compare and make an appropriate decision. For instance, when a patient wants to perform a radiology test, they can compare the charges in two or more hospitals to determine the best option. Transparency in pricing has driven healthcare facilities into pricing competitiveness. Each facility wants to create a competitive advantage with their prices. As such, this benefits the patients because providers are reducing prices effectively to attract more customers. In the long run, making the standard charges open enhances a culture of accountability and integrity in the hospitals (Pear, 2019). As such, this reduces cases of fraud and corruption in the healthcare industry.
References
Hardin, L., Kilian, A., & Murphy, E. (2017). Bundled payments for care improvement: preparing for the medical diagnosis-related groups. The Journal of Nursing Administration, 47(6), 313.
Pear, R. (2019). Hospitals Must Now Post Prices. But It May Take a Brain Surgeon to Decipher Them. The New York Times https://www.nytimes.com/2019/01/13/us/politics/hospital-prices-online.html
Smith, M. (2011). Community/Public Health Nursing: Promoting the Health of Populations [Book Review]. Contemporary Nurse: A Journal for the Australian Nursing Profession, 37(2), 267.
Song, Z. (2014). Accountable care organizations in the US health care system. Journal of clinical outcomes management: JCOM, 21(8), 364.
