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ACOs function under a fee-for-value model, meaning providers get paid if they can keep the costs down and progress patient health. Organizations do this by circumventing unnecessary tests, procedures, and services, thereby focusing on preventive care and keeping patients out of the ER and facility.
FREMONT, CA: Healthcare providers conventionally are paid using a fee-for-service model. The form enables providers to receive money based on the services they offer or the procedures they carry out. In essence, the more services one provides, the more money they make. The predicament of the system is that it does not account for the result of the services or procedures. Mostly, healthcare organizations get paid despite whether the service they provided improved the patient’s health, thus driving up the cost.
Conversely, Accountable Care Organizations (ACOs) function under a fee-for-value model, meaning providers get paid if they can keep the costs down and progress patient health. Organizations do this by circumventing unnecessary tests, procedures, and services, thereby focusing on preventive care and keeping patients out of the ER and facility. If ACOs increase healthcare spending and offer services that do not improve their patients’ overall health, they can receive financial penalties.
Advantages of ACOs
ACOs present a range of advantages to patients and the healthcare system in whole. For instance:
Better Care Coordination: Providers within an ACO are anticipated to coordinate the efforts of all providers that network with a patient, including specialists, primary care providers, hospital facilities, nurses, and others. When organizations coordinate care, there are fewer medical errors.
Condensed Out-Of-Pocket Expenditures: As providers in an ACO are monetarily responsible for their patients’ cost of care, they pay particular attention to ways they can reduce costs. For instance, if a patient needs a minor surgical procedure, a source within an ACO will recommend performing it at a surgical center instead of a hospital to trim down expenses while still presenting the same outcome.
Shared Data: All providers within an ACO share medical reports for the patient, where everyone has access to the data they need to offer high-quality care. When all providers in a patient’s care team have admission to the same information, the quality of care enhances because firms do not need to duplicate services for their records.
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