Now…All
we have to do is cut out Malpractice lawyers! This approach will change the
standard of care, and put the patient’s treatment in the hands of a team, and
not a single physician!
Doctors Rush To
Obamacare's Accountable Care Approach
Forbes 4/27/2013
The number of physicians participating in the
emerging medical care delivery system known as “accountable care organizations”
(ACOs) has tripled as the health care industry moves further away from
fee-for-service medicine.
A new study from Medscape
said one in four doctors, or 24 percent, “were either in an ACO or planned to
be in an ACO within a year.” By comparison, only 8 percent of physicians in
Medscape’s 2012 report were in or planning to be in an ACO. The report
included more than 21,000 doctor respondents across 25 specialties.
“There’s a dramatic change in the number of
physicians who are becoming involved in Accountable Care Organizations,” the
report said. “The focus on ACOs as a care-delivery and cost-containment method
is making an impact.”
ACOs, which reward doctors and hospitals for
working together to improve quality and to control costs, need doctors to be a
quarterback of sorts in using nurses and other caregivers to manage the
medical-care of populations of patients.
ACOs link medical care providers together to
improve quality. If the providers in the ACO achieve better outcomes, they
divvy up money saved with the health plans.
“ACOs are being looked to as one of the tools
for lowering the cost of healthcare,” said Leslie Kane,
executive editor of Medscape Business
of Medicine.
“ACOs can encompass new payment models for
certain health conditions, such as bundled payments,” Kane added. “In a bundled
payment, the ACO receives one set payment for a particular patient’s ‘episode
of care.’ And whichever doctors see or perform services on that
patient, they will all share in that set payment.”
The Medscape report is different than others of
late in that it looked at physicians. A report earlier this year from
consulting firm Oliver Wyman said the ACO approach is also gaining momentum
among U.S. consumers, employers and insurers, saying more than half the U.S.
population has access to ACOs.
ACOs last year began providing medical care
services to seniors through contracts with the Medicare health insurance
program for the elderly. In addition, most private health insurance companies,
too, such as those operated by Aetna
AET +0.23% (AET), Cigna CI +0.39% (CI), Humana HUM +0.56% (HUM), UnitedHealth
Group UNH +1.09%
(UNH), Wellpoint (WLP) as well as Blue Cross plans linking with ACOS to care
for more patients.
Earlier this week, the New York Times followed up on a story the
newspaper wrote about a year ago that featured an effort by Blue
Cross and Blue Shield of Illinois that is achieving some success in how it pays
a Chicago-based healthcare system. Advocate Health Care is reducing hospital
admissions, the insurer and provider said.
A health plan contracts with doctors and
hospitals through an ACO which pushes high quality, less expensive treatment
rather than today’s payment system that often leads to excessive treatment by
paying for each procedure that isn’t always necessarily better. The providers
in an ACO are responsible for managing the care of the health plan enrollees
and are financially rewarded if the enrollees, or patients, stay out of the
more expensive hospital.
“Another reason the government is promoting
them is that there is the strong hope that they will improve coordination of
care for patients, so that it may cut down on duplication of tests, etc.,”
Medscape’s Kane said. “There is also the opportunity with ACOs that if the
organization comes in ‘under budget’ for its patient care, physicians will be
able to share in the profits that are available. Many areas are racing to set
up ACOs, and doctors feel that if they don’t get into them, they may get shut
out of a potential patient pool.”
No comments:
Post a Comment