This paper examines the key conclusions drawn from a team study on accountable care organizations (ACOs), which are networks of doctors and hospitals that coordinate care for Medicare patients. The paper explores four major conclusions: the importance of quality measures for cost control, the need to eliminate duplicate and unnecessary tests, the role of ACOs in preventing worst-case patient outcomes, and the broad benefits ACOs provide to patients, providers, and insurers. The paper also reflects on how the collaborative nature of the team project itself mirrors the coordinated accountability that defines ACOs as a model for modern healthcare delivery.
Accountable care organizations (ACOs) are networks of doctors and hospitals that work together so that patients can receive coordinated care. Organizations that participate must agree to take on Medicare patients for a specific period of time, and they must accept responsibility for those patients while collaborating with one another to provide proper care. Not all doctors and hospitals want to do this, because many feel that they are "locked in" when it comes to agreeing to accept Medicare patients and being responsible for them over the course of several years.
Studying accountable care organizations provides a wealth of information for anyone interested in how doctors and hospitals interact. The main goal of the team project and presentation was to discover how hospitals and doctors work together and what they can accomplish when they focus on patient care above all else. Too often, doctors and hospitals focus on the bottom dollar, or they become preoccupied with the rules, regulations, and guidelines they must follow — and they lose sight of their patients in the process.
The first conclusion drawn by the team is that quality measures are both important and necessary from the hospital's point of view in order to control costs. Contrary to popular belief, lower quality does not always mean lower cost. Often, hospitals and doctors end up spending more on their patients when they do not provide proper care. The thorough implementation of quality care methods across the board is vital to meeting patient needs and keeping costs at a reasonable level in both hospitals and doctors' offices.
Health care costs are already very high, and there are rarely easy ways to reduce them quickly. However, when hospitals and doctors work together, patients can receive better care without incurring unnecessary expenses. This works well because patients can be treated by their own doctor without needing to repeat tests at the hospital. That saves a significant amount of money and allows patients to receive quality care without asking them — or their insurance company — to pay for tests they may not need or may have already had.
The second conclusion is that duplicate and incorrect tests need to be eliminated, and inadequate treatments must be avoided, as both are central measures of care quality. While this may seem like obvious common sense, duplicate and unnecessary tests are remarkably common in today's health care environment. Duplicate tests drive up costs and frustrate patients who have already undergone a particular test and are now being asked to repeat it for a different doctor or hospital. Incorrect tests also raise costs, while simultaneously subjecting patients to unnecessary anxiety and worry.
Such tests will not usually find anything, because they have no connection to the symptoms the patient is presenting. They are simply a waste of time and money — costly to patients and insurance companies alike — and they contribute to the skyrocketing health care costs seen throughout the medical system today. While there are certainly other factors driving rising health care costs, unnecessary and incorrect tests represent a large and avoidable part of the problem.
"ACOs reducing misdiagnosis and preventable deaths"
"Broad stakeholder gains from ACO participation"
"Why more providers should join ACOs"
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