Accountable Care Organizations: Quality Improvement

The formation of Accountable Care Organizations (ACOs) can improve the quality of care and make providers more accountable for the cost of healthcare by facilitating the coordination involving doctors, specialists, medical institutions, and health payers, both private and public. For example, the Centers for Medicare and Medicaid Services (CMS) have established the Medicare Shared Savings Program (MSSP) where ACOs are required to satisfy the quality performance standards and decrease Medicare expenditure by a given proportion.

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It is anticipated that Accountable Care Organizations will be in a position of realizing quality improvement objectives and decreasing the expenses linked to remedial services by ensuring enhanced concentration on patient outcomes and population health management (Chukmaitov, Harless, Bazzoli, Carretta, & Siangphoe, 2015). Novel healthcare provision models such as Accountable Care Organizations provide innovative approaches for caregivers and payers to realize improved patient outcomes and a healthy population.

Medicaid Accountable Care Organizations have achieved a great focus on the prevention of illnesses and upholding wellbeing, which result in effective health improvement. Furthermore, this decreases the possibility that an illness can spread and cause long and expensive hospital stays. The patient community benefits from ACOs through improved quality of care, better patient outcomes, enhanced interaction with caregivers, and a decrease in out-of-pocket expenditures (McWilliams, Hatfield, Chernew, Landon, & Schwartz, 2016).

Accountable Care Organizations will reduce medical costs by essentially transforming the manner in which care is provided. They make caregivers accountable for ensuing costs through a decrease of needless hospital stays, eradication of valueless emergency department visits, better transitions, decreasing the requirement for office visit-anchored healthcare, and improvement of care provided at home through establishment of innovative home diagnostic and disease management expertise.

The strategy toward capitated pay and global financial plans can unlock many openings for innovation of the way in which care is provided. The significance of ACOs on cost reduction will rely on how fast the coordinated care models spread around the nation.

Example of a Study

In their study, Highfill and Ozcan (2016) affirm that under the Accountable Care Organizations model, hospitals willingly assume the accountability of caring for a given population, accept to satisfy the quality and cost standards, and in return receive a proportion of the ‘savings’ obtained from the delivery of excellent care. This research assesses the quality and productivity of early health institutions to embrace the Medicare Shared Savings ACOs plan.

In the study, the selected hospitals, embracing Accountable Care Organizations program, are weighed against their other counterparts in an analysis divided into two sections. The first section compares the productivity of hospitals under Accountable Care Organizations from 2008 to 2012 to health institutions employing Data Envelopment Analysis (DEA), a technique for benchmarking organizational performance. Productivity is broken down into innovation modifications and technical competence.

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The second part of the analysis in the study assesses how health institutions compare on quality pointers from the Hospital Compare report of 2012. The findings show that health institutions that embraced the Accountable Care Organizations plan were more quality conscious and productive than DEA hospitals, which is attributable to an increase in technical effectiveness. Hospitals embracing the ACO program were found to be performing excellently in both quality and productivity standards (Highfill & Ozcan, 2016).

The findings imply that health institutions that embrace the Accountable Care Organizations program have a likelihood of succeeding in tasks that reward quality and effectiveness. This implies that hospitals should join the ACO program as a way of improving the quality of care and patient outcomes.

References

Chukmaitov, A., Harless, D. W., Bazzoli, G. J., Carretta, H. J., & Siangphoe, U. (2015). Delivery system characteristics and their association with quality and costs of care: Implications for accountable care organizations. Health Care Management Review, 40(2), 92-103.

Highfill, T., & Ozcan, Y. (2016). Productivity and quality of hospitals that joined the medicare shared savings accountable care organization program. International Journal of Healthcare Management, 9(3), 210-217.

McWilliams, J. M., Hatfield, L. A., Chernew, M. E., Landon, B. E., & Schwartz, A. L. (2016). Early performance of accountable care organizations in Medicare. New England Journal of Medicine, 374(24), 2357-2366.

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StudyCorgi. 2020. "Accountable Care Organizations: Quality Improvement." December 9, 2020. https://studycorgi.com/accountable-care-organizations-quality-improvement/.

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StudyCorgi. (2020) 'Accountable Care Organizations: Quality Improvement'. 9 December.

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