Accountable Care Organizations: How They Can Help Improve Health Care

“There may be a better way to do things.”

 

If you had to explain why accountable care organizations (ACOs) have sprung to life, that simple sentence might do it.

 

These organizations are charged with finding better ways to deliver health care. And they have the potential to benefit you and members of your family.

 

Teamwork pays

 

ACOs were largely born out of the federal Affordable Care Act, so they’re relatively new. Loosely defined, an ACO is a group of doctors, hospitals and other health care providers who work together to coordinate the care of patients. Currently, most ACOs focus on Medicare recipients.

 

The goal of an ACO is to improve health care–to make it safer, more efficient and less costly for everyone involved. As an incentive to meet that goal, providers in an ACO will share in any financial savings that result from better care–which is defined by a number of quality standards.

 

Among the benefits

 

According to the U.S. Department of Health and Human Services (HHS), 2 out of 3 Americans eligible for Medicare have multiple chronic health conditions–such as diabetes and heart disease–and, as a result, may see several doctors.

 

When that happens, it’s easy for people to miss out on some care they may need; get duplicate care; or be at risk for medical errors, such as taking two or more medications that interact.

 

What’s more, nearly 20 percent of Medicare patients discharged from hospitals are readmitted within one month–many for reasons that are preventable. All of these situations can be troublesome for patients–and costly for hospitals and Medicare alike.

 

ACOs establish the framework for providers to communicate better and work together to address issues like these.

 

Although ACOs may differ in their approaches, ultimately they aim to achieve the same thing: improved patient care at a reduced cost.

 

HHS estimates that ACOs could save Medicare more than $900 million over three years.

 

What won’t change

 

If your provider is taking part in an ACO, you’ll be notified in person or by letter. Your Medicare benefits won’t change. And you’ll still have the right to see any health care provider or be admitted to any hospital that accepts Medicare payments.

 

But you’ll have the advantage of better-coordinated care–and all the rewards that may offer.

 

You can learn more about ACOs at www.healthcare.gov. Type “accountable care organizations” in the search box.

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