Accountable Care Organizations
Accountable Care Organizations are a system of care, payment and delivery which has been designed to facilitate the improvement of healthcare services and lowering costs. They are comprised of hospitals, doctors and other health care providers who offer a coordinated high quality of care to the patients they serve (Fisher & Shortell, 2010).This coordinated care ensures that the patients receive the appropriate care and the right time as well avoiding duplication of services and preventing the occurrence of medical errors. It aims at delivering high quality care and at the same time spending the money allocated for health care in a wise manner.
The accountable care organizations have impacted the healthcare sector in that they have changed significantly how the care is delivered. For instance, the reduction of unnecessary admissions to hospitals and possible readmissions, the improvement of the home care using the newly acquired home diagnostic and treatment technologies have been made possible through the coordinated care by the system (Fisher & Shortell, 2010). Additionally, the improvement of transitions in care as well as facilitating the reduction of the office based care has been made possible by these systems given that these models have spread faster across many states in the country.
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For the healthcare providers, the accountable care organizations have required that they w work together to coordinate care by effectively using health information system, enhance communication among patient’s providers and with the patients as well to ensure that the patients get the appropriate care and that is of high quality. Moreover, the patients have been impacted positively in that the quality of care they receive has been high and the coordination of care has been enhanced. Contrary to how the patient or their family used to be burdened with the responsibilities of bringing pieces of their health information together, the ACOs have helped in fixing this form of care.
Challenges with the Accountable Care Organizations
In as much as the accountable care organizations have positively impacted delivery of care in healthcare institutions, they have been associated with a myriad of challenges. For instance, the lack of a properly defined structure of leadership and management led by the physicians is one of the biggest challenges in the implementation of the quality care by the organizations. Given that the primary source of the investment capital for the required technologies and facilities to be used to deliver quality care is the hospital partners, it is important that the Chief Staff be a qualified physician to enable the maximization of these investments (Rittenhouse, Shortell, & Fisher, 2009). Unfortunately, this has not been the case and as such these accountable care organizations have been not in a position to make the necessary changes to optimize the benefits from these investments. Thus engaging physicians in leadership is crucial in enhancing the use of professional medical guidelines.
Moreover, the incompatibility in the technologies used by physicians and those used by the hospitals differ significantly (Fisher & Shortell, 2010). For instance, their electronic health record systems are not compatible. The inability to share patient data within an accountable care organization limits the productivity and the provision of quality care. Therefore, should there lack a way to connect the technologies that will ensure sharing of the patient information across the care system, the effectiveness and accountability of these organizations becomes questionable (Fisher & Shortell, 2010). To address this challenge, it is advisable to hire the health information support staff who will ensure thy maintain the effective functionality of the electronic health record systems, which will include changing and upgrading of the software as well as facilitating the incorporation of new patient information, diagnosis and treatment.
In addition, the lack by the ACO’s that are hospital based to track and share performance metrics have made it difficult for the healthcare providers to determine whether they are offering the high value or high quality care since they are not aware of the financial consequences of the care they are providing. Notably, when the providers are aware of the type of care they are providing, and the costs they are incurring as a result of that type of care they are able to choose the less costly ones (Fisher & Shortell, 2010). Additionally, without a clear comprehension on the services their patients are using and the costs of these services, the ACOs are usually not able to make the necessary changes to facilitate the improvement of coordinating care as well as reducing the unnecessary spending and utilization of resources.
These challenges call for the healthcare professionals to embrace teamwork which will facilitate the successful implementation of ACOs. In order to provide high quality and coordinated care which is the bedrock principle of the ACOs the roles of the healthcare providers will include collaborating with other care providers across the ACO to achieve optimal results. (Rittenhouse, Shortell, & Fisher, 2009). They will be required to become more conversant with the health information technology which is barring the execution of coordinated services across the ACOs. To enable the communication of the patients information across the providers the healthcare providers will be required to use the health information technology to help in tracking patients medical information which will enable the care givers make informed treatment and prescription choices.
References
Fisher, E. S., & Shortell, S. M. (2010). Accountable care organizations: accountable for what, to whom, and how. Jama , 304 (15), 1715-1716.
Emanuel, E. J., & Emanuel, L. L. (2006). What is accountability in health care?. Annals of internal medicine , 124 (2), 229-239.
Rittenhouse, D. R., Shortell, S. M., & Fisher, E. S. (2009). Primary care and accountable care—two essential elements of delivery-system reform. New England Journal of Medicine , 361 (24), 2301-2303.
