Complementary and Alternative Medicine: Integrating into the Nursing Practice

An ACO are groups of healthcare providers who work together to provide cost efficient care for Medicare patients. Nurses will help an ACO by functioning as a care coordinator of Quality Improvement Manager. Care coordinators will have to manage care with doctor offices, hospitals, rehab centers, and home settings, Quality Improvement Managers will focus on analyzing data and promoting evidence based practices.

ACO, another 3 letter health care organization consisting of integrated groups of providers, comes along promising the elusive goal of reducing health care cost, improving population health, and bolstering custom satisfaction. Sounds like a perpetual remake of a 70s movie called HMO that went through several reiterations over the past decades which gave us PPO, PSO, IDS, and the different flavors of MCOs. ACO’s hype is credited to the Affordable Care Act as it sought to reduce health care costs is by encouraging doctors, hospitals and other health care providers to form networks that coordinate patient care and become eligible for bonuses when they deliver that care more efficiently. Bottom line, providers are promised to make more if they

ACOs provide high-quality care to their patients and reduce cost by avoiding unnecessary duplication of services and preventing medical errors. ACOs may involve a variety of provider configurations, it can range from integrated delivery systems and primary care medical groups to hospital-based systems and virtual networks of physicians such as independent practice associations (McClellan et al, 2010).

In the past few years the American health care system has changed in many ways. First there was the passage of the Affordable Care Act, which is a law that is giving Americans the opportunity to obtain health care. Under this new law, in 2011, the Department of Health and Human Services decided to create Accountable Care Organizations (ACO) to help doctors, hospitals and other providers better coordinate care (AthenaHealth.com). The first idea of an Accountable Care Organization was brought up in 2006 by Elliot Fisher, MD, and now there are over 400 in the United States (Healthcatalyst.com). An ACO’s primary job is to improve health care delivery, performance, and payment. This is done through physicians and

What is the Accountable Care Organization? “Accountable Care Organizations (ACOs) are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients” (www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ACO/index.html). The ACO is a component of the Affordable Care Act (ACA). “The Patient Protection and Affordable Care Act (PPACA) – also known as the Affordable Care Act or ACA, and generally referred to as Obamacare – is the landmark health reform legislation passed by the 111th Congress and signed into law by President Barack Obama in March 2010” (www.healthinsurance.org). One of the main reasons the ACO mainly focuses on Medicare patients because due to the aging, their health problems will become chronic disease and that will have an impact on the healthcare cost years to come. It is stated that about 78% of the total health care is spent for chronic diseases.

I am aware that there is many components to this process and transitioning to this style of patient care may be quite challenging. The primary six guidelines to creating a successful ACO is only the groundwork or blueprint to base organizations on, which most hospitals are expected to adhere by whether they are part of an ACO or not. These six guidelines tie in two major aspects of an organizations financial profile in terms of market characteristics and competitive pressures. Some of

As the continued support grows the PCPCC, the health care sector is recognizing the role of the medical home model, Accountable Care Organizations(ACO), many entities are embracing the model and performing better. According to Center of Medicare and Medicaid, the medical home model shows that there is an improvement cost effectiveness, which helps practitioners deliver quality care and advanced approaches to care coordination, care teams, and chronic disease management. As evaluations of ACOs, integrated health systems, and the medical neighborhood continue, the Patient Center Medical Home will be essential to driving improvements in cost, quality, and outcomes. [3]

The Accountable Care Organization was designed for quality care but it also focuses on the revenue that is brought to the organizations. Furthermore, it can lower costs. Theoretically, ACO’s lower costs and more improve the quality of care. The are both benefits and drawbacks of ACOs. On the positive side, they have been proven to lower costs for the payers. ACO’s have payment aligned with the quality and efficiency of care delivered. ACOs are a new Medicare payment used to help expand Medicare and private payers. ACOs are not an HMO plan or PPO plan. ACOs are used to implement comprehensive payment reform. There are three ACO payment options. These options are Shared Savings, Partial Capitation/Bundled Payment and Full Capitation.

There are three core principles to any ACOs. First, provider-led organizations with primary maintenance and a strong base are liable communally and total per capita costs for quality with full continuum for the population of care for patients. Second, excellent improvements will have linked to also have complete costs reduced, and third, progressively and reliable sophisticated measurement performance to improve, support, and provide the savings of confidence are achieved with improvements of care, , McClellan M, McKethan AN, Lewis JL, Roski J, Fisher ES (2010).

Dr. Bekanich defined the Accountable Care Organizations (ACO) as a group of physicians, hospitals, and other health care providers, working in collaboration to ensure the care provided to their patients is efficient and coordinated, and of the highest quality.

The medicare ACO strategy is based on the concept of reducing the medicare expenditure by moving from a provider fee for service model to a cost controlled model based on a defined network of doctors and hospitals that shares financial and medical responsibility for providing coordinated care to patients at a reduced or fixed price.

The American health care system has been victim to an escalation in the prices of health care services juxtaposed with inefficiency in delivery of care services. There has even been cases where State spending on the actual health care increased dramatically in the United States and one of the key components of curbing this problem which has been prevalent over the mass media and has been a major discussion among physicians is the advent of Accountable Care Organizations. Accountable Care Organizations (ACOs) is structured with the goal of trying to improve health care delivery and aid in the reduction of the overall cost of services (Weissert & Weissert, 2012). If there is insufficient coordination of high quality care delivery in the health care industry, this will have a negative impact on patient safety and diminish affordable care for patients. Hence, the development of ACOs is envisioned to be the savior of medical practices and can improve the overall fabric of the American society (Bresnick, 2013). ACOs serves as one of the answers for curbing the problem of high costs, low quality care and possible segmented delivery and as much as it serve as the major determinant for improvement in patient satisfaction, there are minor

"The ACO is a concept that a complex of health care professionals, primary care providers, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and hospitals, agree to coordinate information, health care regimens, and payment plans to make the care of patients more

An Accountable Care Organization or ACO is a group of doctors, hospitals, and healthcare providers, who voluntarily come together and provide coordinated high quality medical care to Medicare patients.

ACOs intensity the incentives to improve the quality and reduce the cost in health care. The coordinated care provided by an ACOs is to ensure that patients and populations are especially the person chronically disease get the right care, at the right time and placed without any harm, while avoiding care that has no proven benefit or represents an unnecessary repetition of services. Also, having the potential to reduce the number and significance a medical error in the United State.