Preview

What are Accountable Care Organizations and are They Really Going to Help?

Best Essays
Open Document
Open Document
3935 Words
Grammar
Grammar
Plagiarism
Plagiarism
Writing
Writing
Score
Score
What are Accountable Care Organizations and are They Really Going to Help?
What are Accountable Care Organizations: and Are They Really Going to Help? Park University: HA 604, Health Care Economics and Payment Systems
Abstract
In the 1980s and 1990s Health Maintenance Organizations (HMOs) were the next big thing in the health care community. At the time, this form of health insurance was believed to be end all solution to high, and getting higher health care costs. The Government quickly started using HMOs and its different forms for their federally funded health insurance companies of Medicare and Medicaid. Thirty years have passed since the hay day of HMOs, and the U.S. Government has deemed that HMOs are just not working any more, the cost of health care continues raise, and we need to fix the problem. What is the solution? Accountable Care Organizations (ACOs)! To many people, these organizations are just HMOs with bright red lipstick, but nothing else has really changed. Let’s call it an HMO hybrid. This paper takes a closer look at ACOs, their history, track record, and views from leading authorities on their effectiveness. The paper will also give topics of consideration that all physicians should look into, before deciding if they should join an HMO with lipstick. I mean an ACO.

Insert Paper Title Here During the 1970s- and early 1990s, Managed Care Organizations (MCOs) dominated the face of health care. They were an attempt by the government and insurance agencies to help reduce the rising and expensive costs of healthcare. In some ways these plans were effective, and in others they were not. MCOs are still very present today in health care, however the bill known as the Affordable Care Act of 2010 (ACA) included plans to change the face of MCOs as we now know them. In order to do so, plans have been made to form and introduce Accountable Care Organizations (ACO). This plan has been described as being just another integrated delivery system linking physicians together

You May Also Find These Documents Helpful

  • Better Essays

    Managed care organizations can save money by providing lower prices through contracting large volumes of services and reducing the amount of hospitalizations (Getzen & Allen, 2011). This essay presents a scenario in which I am a representative of Castor Collins Health Plans responsible for maximizing profits and minimizing risks. Within my job description, I am advised to develop a comprehensive health insurance plan for two entities: ConstructIt and E – Editors. This essay explains the company’s employee demographics, health risk factors, premium amount the company is willing to pay, and what company I chose to offer a health insurance plan. Based upon my analysis of potential utilization, I will provide two reasons…

    • 1187 Words
    • 5 Pages
    Better Essays
  • Satisfactory Essays

    A difference is, ACOs are more truly integrated compared to HMOs. The ACOs integration is accomplished through organizational structure and through sharing of electronic records, neither of which were common with early HMOs. There is now more information about how to manage care than there was in the early days of HMOs. ACOs can take advantage of health care guidelines, quality metrics and knowledge about patient costs. Finally, there is an increased emphasis on measurable outcomes, which will help ACOs reach performance goals and benchmark their performance. ACOs like HMOs do not rely on full capitation. Instead, they usually put providers at risk for a portion of the cost of care; that risk is shared with insurers, somewhat sidestepping a…

    • 206 Words
    • 1 Page
    Satisfactory Essays
  • Good Essays

    Economic Issues Simulation

    • 1040 Words
    • 5 Pages

    Health Maintenance Organizations (HMOs) have an important role to their patients and their health care providers. Castor Collins Health Care Plan was found in the year of 1999, in Pantome. This particular HMO service provide health care insurance and health care services to a variety of physicians and hospitals. This company used the capitation idea for compensation to pay its health care providers. Castor Collins is currently serving 100,000 members, throughout Pantome, and is looking for ways to increase the their numbers.…

    • 1040 Words
    • 5 Pages
    Good Essays
  • Satisfactory Essays

    It is common knowledge that the ACA has granted more Americans access to health care insurance. As discussed earlier, the increase in insured persons means more patients in the already burdened health care system. The up-front cost of providing care to nearly 16.4 million Americans will be great to health care providers and organizations. The ACA presented new concepts to health delivery that move away from the traditional fee-for-service payment model in hopes to increase quality of care, improve patient outcomes, reduce costs, and increase savings to providers and organizations. The Accountable Care Organization (ACO) is a model implemented by the ACA to allow economic incentives for organizations.…

    • 287 Words
    • 2 Pages
    Satisfactory Essays
  • Good Essays

    ACO Implementation

    • 1326 Words
    • 6 Pages

    ACOs are expanding outside of the Medicare setting and private health insurance companies are considering or trialing the use to decrease expenditures. The overall hope is that ACOs will bring HCPs, hospitals, and the interdisciplinary team to work together to improve quality and decrease healthcare expenditures (Fischer & Shortell, 2010).…

    • 1326 Words
    • 6 Pages
    Good Essays
  • Good Essays

    Aco Review and Discussion

    • 852 Words
    • 4 Pages

    “In light of the high and rapidly growing cost of healthcare in the U.S., there has been growing interest both in the federal government and in states and regions across the country in finding ways to encourage health care providers to take greater accountability for the overall cost as well as the quality of healthcare delivered to patients. A healthcare provider or group of providers that accepts accountability for the total cost of care received by a population of patients has been termed an “Accountable Care Organization”’ (http://www.chqpr.org/)…

    • 852 Words
    • 4 Pages
    Good Essays
  • Powerful Essays

    The Affordable Care Act is the largest piece of legislative reform in American history relating to health care. The impact to our economy on many levels of scale and our constitutional rights are all being questioned and debated without a definitive answer to long term reality of its implications. Reform is necessitous to the continuance of providing care, controlling fraudulent activities and waste, as well as, exploring new innovative ways to maintain a high level of quality services within the legalities of our legislative branch. The balance of these aspects have been challenging and perplexing in materializing the reforms into fruition. The concentration during reform has been on quantity of the insured population, effects on businesses as in tax benefits, taxation, and the CMS. The ACA, legislatively is in the beginning stages to reform health care. Thus far the application of reform are in disarray as it is on the operating table cut wide open and bleeding out, without a surgeon in the room. The complexity has the medical society and American constituents confused and anxious of its impact. Providers have great apprehension of more government intervention, less…

    • 3962 Words
    • 12 Pages
    Powerful Essays
  • Better Essays

    health care system is dysfunctional and can no longer continue as it currently operates. With or without Affordable Care Act (ACA), there is a need for a deep change. The United States spends more money on health care because a nation is less healthy on the average than the rest of the developed world. The system is dysfunctional and ACA is fast-tracking the process of changes that will be faced by the economic and business challenges by health care organizations. The required adjustments to healthcare organizations operating budgets and methodologies for delivering medicine may become a big issue. Health care organizations will have to go from volume-based reimbursement in medicine based on the number of procedures done or patients seen to a value-based system that will give the same money for every patient regardless of the procedure performed. Health care organizations may have lower income since they will treat more patients. They may face cost-pressure factors such as the overall cost of medical care and the increased incidence of chronic disease, cost transparency and reference pricing, increased government role in paying for care, increased coverage and limited highly skilled medical workforce There is a prediction that forty million more people will be covered nationally, at reimbursement rates below the cost of providing that care (Adams et al.,…

    • 1835 Words
    • 8 Pages
    Better Essays
  • Satisfactory Essays

    Felicia, thanks for your post, I reviewed your study on Medicaid and it saddens me to hear that this this the worst health care insurance to have because Today the majority of the population is on Mediciad. “Medicaid serves as the nation’s primary source of health insurance coverage for low-income populations” (CMS. gov., 2015). This places the low income families at a disadvantage for quality care. (Political Irony, 2014). Would ACO’s be able to provide quality managed care for this group? If so I would say we have to evaluate its benefits and it outcomes. This can be good for health care reform.…

    • 127 Words
    • 1 Page
    Satisfactory Essays
  • Better Essays

    Evolution of Managed Care

    • 1519 Words
    • 7 Pages

    References: Davis, K., Collins, K., & Morris, C. (2006). Managed Care: Promise and Concerns. Retrieved on August 25, 2010, from http://content.healthaffairs.org/cgi/reprint/13/4/178.pdf…

    • 1519 Words
    • 7 Pages
    Better Essays
  • Better Essays

    With healthcare spending steadily on the rise in the United States, healthcare payers are beginning to make the shift from volume-based to value-based payment regimes. The main focus in doing so is to improve the quality of care while reducing the cost. One type of value-based approach is an Accountable Care Organization (ACO), which is defined as a “group of healthcare providers who agree to share responsibility for the quality, cost, and coordination of care for a defined population of patients.” There are three core features of the ACO model. The first is that the ACO consists of a strong base of primary care health provider organizations; the second is that performance measurement is designed to support ongoing improvement in patient care…

    • 1573 Words
    • 7 Pages
    Better Essays
  • Good Essays

    Although managed care seems to have been effective in reducing the physician bias for overtreatment of patients, it has created conflict between physicians and patients, whether they are genuinely caring about the quality of service. Another issue where managed care can affect the quality is replacing highly trained health professionals with those that has less experience to save on cost (Tietze, 2003). According to the article “Impact of managed care on healthcare delivery practices”, both administrators and practitioners have a role in maintaining awareness regarding their perceptions and should collaborate to address issues of concern. Such as promoting trust and commitment on within the…

    • 1086 Words
    • 5 Pages
    Good Essays
  • Good Essays

    US health care expenditures have been rising quickly over the past few years; it has risen more than the national financial system. Nonetheless a number of citizens in the US still lack appropriate health care. If the truth be told, health care expenditures are going to continue to increase; in addition numerous individuals will possibly have to make difficult choices pertaining to their health care. Our health system has grave problems that require reform, through reforming, there is optimism that there will be an increase in affordable health care and high-quality of care for America. Medicaid, Medicare and private sector insurances are all going through trials and tribulations because of spending. Obama Cares purpose is to put consumers back in charge of their health care and aid in driving down the cost of spending in health care. The reform will also strive to put forward a delivery system that operates better for all involved thereby decreasing organizational burdens and assisting in the collaboration towards improved care. If the reform is successful, it will lead to measureable improvements in care outcomes, and in the health of the American general public overall.…

    • 769 Words
    • 3 Pages
    Good Essays
  • Powerful Essays

    Understanding Change

    • 1779 Words
    • 6 Pages

    In March of 2010, President Barack Obama signed into law The Patient Protection and Affordable Care Act (PPACA); legislation which has since become more commonly known as The Affordable Care Act (ACA) to industry professionals, and more colloquially as ‘Obamacare’ to the American people. However, many of the required changes necessary for healthcare organizations to remain compliant to the federal mandates have yet to take place. The implementation of industry changes on a magnitude as those facing American health providers is both incredibly difficult and complex.…

    • 1779 Words
    • 6 Pages
    Powerful Essays
  • Good Essays

    Affordable Care Reform

    • 1656 Words
    • 7 Pages

    There have been numerous failed attempts to reform the United States healthcare system over the years. However, the most recent attempt that has been implemented is the Affordable Care Act, under the Obama Administration. As a result, since 2010 changes have been implemented to reform the United States healthcare industry, which affects the insurers, providers, and the subscribers in different ways. Consequently, the Affordable Care Act does not have full support from everyone and it faces numerous challenges (Bodenheimer & Grumbach, 2012). Overall, it is estimated that 2.6 trillion dollars is spent on healthcare in the United States each year (Van Gorder & Topol, 2012). Therefore, it is essential to acknowledge the inflation in healthcare…

    • 1656 Words
    • 7 Pages
    Good Essays