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NUR 514 Topic 5 DQ 2 Define ACOs and discuss their impact on the contemporary health care system

NUR 514 Topic 5 DQ 2 Define ACOs and discuss their impact on the contemporary health care system

Define ACOs and discuss their impact on the contemporary health care system. How do ACOs drive cost-effectiveness, innovation, and collaboration in the delivery of health care?

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Accountable Care Organizations (ACOs) are composed of physician groups, hospitals, and other professions that provide health care to provide quality, systematic care to Medicare patients. ACOs tend to reduce health care costs through the coordination of care that eliminates overlapping or duplicated methods of care. All members must collaborate to create a smooth transition in care to achieve maximum reimbursement. ACO members are driven to create innovations that improve care and reduce costs to receive full reimbursement from Medicare. Within this idea, many programs have been created to provide optimal patient outcomes. The total joint replacement initiative seeks to optimize patients, reduce the recovery period, minimize complications, and decrease health care costs. The joint replacement center addresses areas of nutrition, wound healing, deep vein thrombosis prophylaxis, pain control, medications for nausea, early ambulation, and physical and occupational therapy. These areas are addressed to prevent complications and hospital readmissions. Perioperative service at the hospital I work at has established clinical pathways that utilize evidence-based practices for optimal care. This is a beneficial scenario for patients. The nation’s health care personnel must collaborate to develop innovative ideas to maximize patient outcomes while reducing costs. D’Aunno et al. (2018) identify several factors of high-performing ACOs. These components are physician collaboration with hospitals, optimal physician group practice before ACO adoption, effective physician leaders focused on high-quality care, adept use of information systems, constructive feedback to physicians, and care coordinators (D’Aunno et al., 2018). Addressing these areas in an ACO will assist in providing optimal care with resultant reimbursement.

References

D’Aunno, T., Broffman, L., Sparer, M., & Kumar, S. R. (2018). Factors that distinguish high-performing accountable care organizations in the medicare shared savings program. Health Services Research53(1), 120–137. https://doi.org/10.1111/1475-6773.12642

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McAlearney et al. (2018) states “Across the health care landscape in the United States, momentum is shifting away from volume-based care and building toward value-based care most often interpreted as a function of reducing cost while simultaneously improving quality.” (p. 4767) Accountable care organizations involve organizational partnerships for the purpose of coordinating patient care

NUR 514 Topic 5 DQ 2 Define ACOs and discuss their impact on the contemporary health care system

NUR 514 Topic 5 DQ 2 Define ACOs and discuss their impact on the contemporary health care system

across the health care continuum to improve health outcomes. ACOs focus on outcomes as this is what drives reimbursement. Improving care while reducing costs may require innovative use of existing resources and use of innovative means of achieving treatment goals. Looking at the end result is a straightforward way of quantifying the efficacy, and quality of the services delivered by participating providers. 81% of ACOs involve new partnerships between independent health care organizations whose providers are motivated to partner for resource complementarity, risk reduction, and legislative requirements, and are using a variety of formal and informal accountability mechanisms.” (Lewis et al., 2017, p. 25) Value-based reimbursement creates the incentive for ACOs to manage patient care across health care settings, requiring improved care coordination among providers. These efforts reduce unnecessary health care utilization, improve patient outcomes, and reduce health care spending. (Agarwal & Werner, 2018)

References

Agarwal, D., & Werner, R. M. (2018). Effect of Hospital and Post-Acute Care Provider Participation in Accountable Care Organizations on Patient Outcomes and Medicare Spending. Health Services Research53(6), 5035–5056. https://doi-org.lopes.idm.oclc.org/10.1111/1475-6773.13023

Lewis, V. A., Tierney, K. I., Colla, C. H., & Shortell, S. M. (2017). The new frontier of strategic alliances in health care: New partnerships under accountable care organizations. Social Science & Medicine (1982)190, 1–10. https://doi-org.lopes.idm.oclc.org/10.1016/j.socscimed.2017.04.054

McAlearney, A. S., Walker, D. M., & Hefner, J. L. (2018). Moving Organizational Culture from Volume to Value: A Qualitative Analysis of Private Sector Accountable Care Organization Development. Health Services Research53(6), 4767–4788. https://doi-org.lopes.idm.oclc.org/10.1111/1475-6773.13012

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