Need response to below discussion question 1 reference 75 words apa format

Unit 5 Topic 1

Roma Patel posted Feb 3, 2018 11:30 PM

Accountable Care Organizations (ACOs) are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality, care to their Medicare patients (Accountable Care Organizations, 2017). This basically means that with ACO’s brings together the different component parts of care for the patient – primary care, specialists, hospitals, home health care, etc. – and ensures that all of the “parts work well together.” One way ACOs help improve quality of care is by making sure their patients are avoiding unnecessary tests and procedures. ACOs need to make sure that they are always sharing information. Providers are more responsible for the cost of care by creating incentives to be more efficient by offering bonuses when providers keep costs down (Gold, 2011). The way this works is the providers need to meet specific quality benchmarks, focusing on prevention and carefully managing patients with chronic diseases. In other words, providers get paid more for keeping their patients healthy and out of the hospital (Gold, 2011). The move toward capitated payments and global budgets can unleash many opportunities for innovation in how care is delivered. One element ACOs need to have is a primary care physician basically who acts as the captain of the program. There was a study led by Dr.McWilliams that found for ACOs entering in 2012, participation in the Medicare Shared Savings Program was associated with a 9% differential reduction in postacute spending by 2014, driven by reductions in discharges to facilities, length of facility stays, and acute inpatient care (McWilliams, Gilstrap, & Stevenson, 2017). In this study they took a sample of fee-to-fee Medicare claims and compared it to beneficiaries served by ACOs. This was before and after they entry into the Medicare Shared Savings Program. The result of the study for the 2012 cohort of 114 ACOs, participation in the MSSP was associated with an overall reduction in postacute spending (McWilliams, Gilstrap, & Stevenson, 2017). The conclusion of the study showed spending reductions was more consistent with clinicians working within hospitals and SNFs to influence care for ACO patients. This is a successful study because it showed ACOs can be beneficial in reduction in spending.

References

Accountable Care Organizations. (2017). Centers for Medicare and

Medicaid Services. Retrieved from

https://www.cms.gov/Medicare/Medicare-Fee-for-Service-

Payment/ACO/

Gold, J. (2011, January 18). Accountable Care Organizations, Explained.

Kaiser Health News. Retrieved from https://khn.org/news/aco-

accountable-care-organization-faq/

McWilliams, M., Gilstrap, L., & Stevenson, D. (2017). Changes in

Postacute Care in the Medicare Shared Savings Program. JAMA

Internal Med, 177(4). doi:10.1001/jamainternmed.2016.9115