Can financial incentives and doctor practice structures be enlisted o enhance the ability and reduce the cost of healthcare? health Care Reform supporters believe they can and the new Ppaca signed into law by the President recently provides incentives for the amelioration of Acos for Medicare patients. Acos have been described as Hmo's on steroids, but many wonder either they will meet the same fate as the managed care systems of the past that focused on blind leveraged cost reductions and suitable beneficiary choice to achieve profits.
Acos are independent organizations (some virtual) including independent physicians, practice groups, ancillary care providers and hospitals organizing among themselves, without guarnatee companies, for the clinical integration of outpatient care, with peer oversight to assure ability and continuity of care and the mutual sharing of cost savings.
Kaiser Medical
One of the most intractable problems in health care reform relating to both ability and cost is the "cottage industry" nature of medical practice in the U.S. One third of all doctors here function in practices of one or two physicians; 15% in 3 to 5 physicians and 19% in 6 to 50 physicians. They are mostly paid in a fee for services ideas that rewards volume of services and procedures provided with miniature or no concern given to the ability or consistency of performance. The Dartmouth Atlas project at the Dartmouth medical School has for years tracked a wide disparity in medical care across the United States.
In 2006, Dr. Elliot Fischer from the Atlas project and others published a paper, "Creating Accountable Care Organizations: The extended Hospital medical Staff" in health Affairs wherein he advocated greater peer coordination and oversight to reduce the costs and growth the ability of care in our health care system. This model requires the productive use of electronic medical records and multidiscipline care terms and a willingness for participants to be routinely assessed and held accountable for performance.
The implementation of Acos wish a great deal of change and assosication in an business largely and historically hyper-invested in the status quo. There is a need for a critical change in the underlying infrastructure of victualer practice which will wish large victualer buy-in, an outcome that cannot be imposed externally. There is a need for the incorporation of technology and best doctor clinical practices into the daily framework of service. There is a need to claim a consistent base of patients over defined periods of time to be able to portion operation longitudinally. There is a need for victualer protection from catestrophic outlier risk and the factory of reachable financial incentives.
That is a lot to chew on, but there can be a lot learned from the successes and failures of Intermountain Health, Kaiser, Geisinger and other integrated service organizations which may be pointing a way to a time to come where the health care business moves haltingly but irrevocably into the industrial, if not the technological age.
over here supplier Integration And The coming Of Accountable Care Organizations ("Acos")
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