The upfront ACO model is an innovative model that aims to improve the quality of service and payment. The upfront payments received under the model involved investment in their care coordination infrastructure (CMS, n.d.). The purpose of this program was to enable small ACO to participate in the creation of general savings and prominent representatives (CMS, n.d.). Despite directly related to finances, this model mainly aims to improve quality rather than payment. Since to help regional ACO improve their operational performance by providing capital funds that should be used to improve infrastructure; thus, the level of delivery of medical services on a national scale should be equalized, which will improve the quality of service and the reputation of Medicare and Medicaid.
The transition from a volume-based to a value-based payment plan in the context of this model can be explained as follows. ACO, with little capacity, due to the lack of capital for development, cannot provide advanced technologies in medical services due to their high cost. At the same time, they can often serve a sufficiently large number of people. Value plays a more significant role than volume since the related services have different selling prices, which often do not depend on the volume of services provided. The impact of this model on the qualitative side of Triple Aim has partly explained above: additional capital injections contribute to the development and not just the closing of fixed operating expenses. From the point of view of equity, there is a narrowing of the gap between advanced medical institutions, the capital of which is enough for both current activities and further development, and, as a result, every person in the country has equal opportunities for treatment. Finally, the efficiency is explained by the improvement in the quality of infrastructure, facilitating the implementation of modern treatment methods through the purchase of expensive equipment or the involvement of highly qualified specialists.
Reference
CMS. (n.d.) Advance Payment ACO Model.