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Even worse, because the negotiated rates for services is so much lower than the non-insured rates for those services, many providers may actually provide services more liberally than necessary to make up for the lower revenue of each service rendered.
Eventually, I believe the only way to really address the problem of healthcare costs is to adopt the results-based compensation structure already successfully in use in Britain. Unfortunately, such profound systemic changes will be tremendously difficult to implement in the U.S. In the meantime, therefore, the ACO concept may be the most viable means of incentivizing healthcare cost reduction on the part of providers as well as patients.
Relevance to Risk Management Concepts
Another aspect of increased flexibility associated with ACOs in comparison to HMOs is that ACOs encourage patients to utilize network providers but also permit...
This, however, also represents the greatest risk of its failure. Patients can be encouraged to select network providers by coordinating their premium payments with those choices so that patients who refrain from going out of network pay lower premiums than patients who choose to go out of network. However, the fiscal savings that are the primary benefit of the system depend on a high degree of voluntary patient compliance. Precisely because ACOs allow greater flexibility that HMOs, this also is their greatest risk of failure should patients lack confidence in the system. To mitigate this risk it is likely essential that ACOs provide incentives for voluntary cost-savings choices that are sufficient to overcome the resistance of patients to submit to yet another healthcare system acronym that is supposed to solve the nation's healthcare problems.
The healthcare landscape is undergoing a paradigm shift, transitioning from a volume-based system to one focused on value and accountability. Accountable Care Organizations (ACOs) play a crucial role in this transformation, aiming to improve healthcare quality, reduce costs, and enhance patient experience for designated populations. This essay delves into the impact of AdventHealth, a prominent ACO, on healthcare quality and metrics, analyzing its successes, challenges, and overall contribution to a
Medicaid and the ACA Discuss the issues central to the expansion of Medicaid created by the Affordable Care Act. From state policy perspective is this a good way to increase access to healthcare at a reasonable cost? Be sure to discuss the success stories you uncover as you complete your research for this question. Review the following and consider the questions below as part of your initial post. From the State's perspective,
ACA and EMS The implementation of the Affordable Care Act (ACA) is sure to change the way EMS operate in the coming years. Accountable Care Organizations (ACO), for instance, are now responsible for overseeing how reimbursements are paid out to those agencies that provide health care -- and at the same time they are responsible for gauging whether or not quality care is delivered by providers (Koury et al., 2014). This
Growth and Changes in Nursing Now that the Affordable Care Act (ACA) is the law of the land, nurses can expect to have even more responsibility and even more opportunities to use their skills. This paper reviews how the restructuring of the U.S. healthcare system impacts the nursing field. And this paper reflects on how continuum of care, accountable care organizations, medical homes and nurse-managed health clinics will be affected
Obamacare good for the economy? The issue must be looked at from three points-of-view, One the development that goes on in the health care and how the policy ahs affected the health care industry and particularly various sections of the society, secondly the economic changes and developments that have come about in the medical care industry, and the burden and changes in the nations economy as a whole and whether
What this means is that the lifetime limits on most benefits are barred for all latest health insurance plans. Another interesting thing is the reviews premium increase (Wakefield, 2010). This is saying that insurance companies must now openly defend any type of unreasonable rate hikes. The last thing is that it helps a person get the most from all of their premium dollars. In other words, a person's premium