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
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?
Physician groups, hospitals, and other healthcare providers form Accountable Care Organizations (ACOs) to give Medicare patients high-quality, organized care. ACOs have a tendency to lower health care costs by coordinating care to get rid of redundant or overlapping methods of care. To receive the highest possible reimbursement, all participants must work together to provide a seamless transition of care. In order to earn the full amount of Medicare reimbursement, ACO members are motivated to develop innovations that enhance care and lower costs. Numerous programs have been developed to offer the best patient outcomes under this concept. The complete joint replacement project aims to improve patient outcomes, shorten recovery times, reduce problems, and lower medical expenses. Nutrition, wound healing, deep vein thrombosis prevention, pain management, nausea drugs, early ambulation, and physical and occupational therapy are all topics covered by the joint replacement center. In order to avoid difficulties and readmissions to the hospital, these issues are addressed. In order to provide the best possible treatment, the perioperative service at the hospital where I work has established clinical pathways. For patients, this situation is advantageous. The nation’s health care professionals must work together to create cutting-edge concepts to improve patient outcomes while lowering expenses. Several characteristics of high-performing ACOs are identified by D’Aunno et al. (2018). These include care coordinators, successful physician leaders who are committed on providing high-quality care, adept use of information technologies, physician collaboration with hospitals, and ideal physician group practice prior to the establishment of ACOs (D’Aunno et al., 2018). By addressing these areas in an ACO, you can deliver the best care and get paid for it.
Re: Topic 5 DQ 2
Accountable Care Organizations (ACOs) are made up of physician groups, hospitals, and other health-care providers who work together to provide quality, systematic care to Medicare patients. ACOs minimize health-care costs by coordinating care and eliminating redundant or duplication methods of care. To secure optimum reimbursement, all members must work together to provide a smooth transition in care. ACO members are motivated to develop innovations that improve treatment while lowering costs in order to earn full payment from Medicare. Many programs have been developed around this concept in order to deliver the best possible patient outcomes. The complete joint replacement project aims to improve patient outcomes, shorten recovery times, reduce problems, and lower health-care expenditures. Nutrition, wound healing, deep vein thrombosis prevention, pain control, nausea drugs, early ambulation, and physical and occupational therapy are all addressed at the joint replacement clinic. These issues are addressed in order to avoid difficulties and hospital readmissions. The perioperative service at the hospital where I work has established clinical pathways that use evidence-based approaches to provide the best possible care. This is a win-win situation for patients. The nation’s health-care workers must work together to come up with new ways to improve patient outcomes while lowering expenses. Several criteria of high-performing ACOs are identified by D’Aunno et al. (2018). Physician collaboration with hospitals, optimal physician group practice prior to ACO adoption, effective physician leaders focused on high-quality care, adept use of information technologies, constructive feedback to physicians, and care coordinators are among these components (D’Aunno et al., 2018). Addressing these issues in an ACO will aid in providing optimal treatment and, as a result, reimbursement.
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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 Research, 53(1), 120–137. https://doi.org/10.1111/1475-6773.12642
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Re: Topic 5 DQ 2
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 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 Research, 53(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 Research, 53(6), 4767–4788. https://doi-org.lopes.idm.oclc.org/10.1111/1475-6773.13012
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