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Happier Patients and Better Quality of Care with ACOs

happy patient due to better quality of care with ACOsAccountable Care Organizations are projected to save taxpayers $940 million within four years, accordingly to the Center for Medicare and Medicaid Services (CMS). Accounting for seven pages of the Affordable Care Act, Accountable Care Organizations (ACOs) have become a rapidly growing segment of the health care industry.

In addition to cutting costs, ACOs are also intended to increase quality of care and enhance overall patient satisfaction. But, while ACOs have these abilities, the hopes are not always the reality.

In order to make good on their promises, ACOs have a few barriers they must overcome. First and foremost, they must revise outdated payment models, such as the fee-for-service approach. This model does not take into account the relevancy or outcome of provided services, but simply reimburses more money to physicians when additional and more advanced procedures are performed.

Another obstacle to overcome is having appropriate staff in place to heighten the quality of care patients receive. In a study regarding the effectiveness of ACOs since their start in 2012, physicians’ ratings from patients, patient-physician interactions and the overall quality of care were not showing significant improvement. ACO patients did, however, report an increase in the accessibility and coordination of care.

ACOs are enticing to facilities due to the attainable Medicare savings, as long as quality is improving and costs are decreasing. But, some believe they’re not tempting enough. Ultimately, increased legislation is necessary to further encourage participation in ACOs and implementing refined payment models.
Improving Quality of Care with ACOs Through Patient Engagement
With the overall goal being to improve quality of care with ACOs, that effort starts by enhancing patient engagement. According to the Bipartisan Policy Center, increased patient engagement leads to:
• Reduced diagnostic testing and expenditures
• Fewer referrals
• Fewer elective surgeries
• Increased adherence to prescribed medical treatments
• Increased functional status and faster recovery
• Higher levels of satisfaction
• Higher levels of health literacy
• Higher levels of positive health-related behavior changes

In addition to increasing the quality of care, patient engagement also leads to reduced medical spending—another goal of ACOs. With cohesion and understanding between physician and patient, concerns can be addressed, errors are avoided and duplication of services can be averted.

With the transition away from fee-for-service billing models and into quality-focused reimbursement, focusing on patient engagement ultimately helps physicians achieve their financial incentives as well.

The entire health care industry is undergoing major change. Not every effort is going to be perfect, but at least steps are being taken. Currently, ACOs are scored on 33 different quality measures. While some measures may decrease as others increase, overall year-two results for Pioneer ACOs improved 14.8% across all categories, and Shared Savings Program ACOs improved on 30 of 33 measures, according to CMS.

One major success was nearly all ACOs receiving the maximum points available for lowering hospital admission rates. Not only does reducing hospital readmissions result in major cost savings, but also makes a strong contribution to increasing patient quality of care and overall satisfaction.

Simply being a part of an ACO is not enough to reap the benefits they have to offer. In order to do so, facilities need to make serious commitments to revamping the way daily operations are conducted. General Medicine, The Post-Hospitalist Company has long-term and post-acute professionals to help your organization meet the changing standards and achieve success.

Our goals include reducing hospital readmission rates, lowering medical spending and providing the best quality of care with ACOs—let’s improve health care together.

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Tom Prose