In what ways can an ACO succeed in both delivering high-quality care and spending health care dollars more wisely?
In what ways can an ACO succeed in both delivering high-quality care and spending health care dollars more wisely?
PROVIDE A RESPONSE OR STATEMENT TO THIS STUDENTS DISCUSSION:
Please share your experience on selecting a managed care plan. Please discuss the advantages and disadvantages of your MCO plan.
Honestly, I do not have any experience choosing an MCO plan. We are a military family and our insurance is chosen for us. That being said the advantages to the plan are that we didn’t have to spend our time researching and trying to choose a plan, we don’t have to pay enrollment fees or monthly premiums, and as long as we see a military provider at a military treatment facility we do not have to pay any out of pocket costs. The disadvantages to our plan are that we have no choice in our insurance provider, we have to go through our PCP to get a referral and they are hard to get, our choices of physicians are limited to whichever doctors are currently stationed where we are, our physicians frequently move and we are assigned to yet another new doctor, and long wait times for an appointment with our PCP due to staff shortage.
Many argue that there is no consistent, direct correlation between the cost of care and its quality in a managed care program. Do you agree or disagree?
From my experience, we do not pay for our care and have little choice in who we can see. Sometimes our physician is awesome and sometimes they are not. I understand that the goal is prevention and limiting unnecessary medical expenses but sometimes specialist care is needed. Some doctors are more than capable of providing the care that is needed but some are not. MCOs don’t give the patients many options and unfortunately the quality of their care may suffer.
Do you think patient’s choice of provider and access to care will be limited under ACOs?
As with any form of healthcare the patient’s choice of provider may be limited. This is unavoidable as I don’t know any provider who accepts all forms of insurance. I do not think access to care will be limited, except perhaps in cases of geographic isolation where options may be limited in general.
In what ways can an ACO succeed in both delivering high-quality care and spending health care dollars more wisely?
The whole purpose of ACOs is to coordinate healthcare in such a way that access to care is increased, unnecessary services reduced, and the right care is provided at the right time to reduce costs. As long as ACO can provide a large selection of providers, keep access open, and costs down, I think the patients will be satisfied with their care. The providers are rewarded for doing these things which provides continuous motivation to hit or surpass the target goals.
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