Implementing The Affordable Care Organizations

There are several types of private payer plans including preferred provider organizations (PPO’s), health maintenance organizations (HMO’s), and point of service (POS). Indemnity plans would cost the most for employees and they usually choose a PPO plan. A trend that is gaining popularity with employees and employers is the consumer driven health plan (CDHP) that has a high deductable combined with a funding option of some type. All of the plans have unique features for coverage of services and financial responsibility.

Healthcare is often driven by consumers and insurance companies; there is strong pushes for insurance companies to start paying better through Patient Care Medical Homes (PCMH) or Accountable Care Organizations (ACO) rather than paying at a per-visit basis (Hamlin, 2015). With PCMH or ACOs payment is made on a continuum of care, encouraging the provider to be involved in all aspects affecting health of the patient (Derksen, & Whelan,

EPO vs HMO-- EPO contracts solely with specific specialists, clinics, hospitals and other health care providers to form a network. EPO clients know they don't have many options when it comes to providers, but they do have the comfort of knowing they'll always be reimbursed for any in-network expenses. HMO’s requires a co-payment on each visit while EPO’s have no co-pays. Both EPO’s and HMO’s keep costs low. EPO’s do not require a referral while HMO’s must confirm that specialized care is required before they will issue a referral

The Affordable Care Act (ACA) strives to improve the quality of the lives of Americans. The most current healthcare policy that endorses the ACA, is the ObamaCare initiative that has received a fair share of both support and criticism. (Hwang, et al. 2013) talks about the “Effects of the integrated delivery system on cost and quality”. According to the authors, most people criticize the American healthcare system because of its complexity, high cost and excessive fragmentation. The same scholars confirm however that the fragmentation and the provision of various services, benefit different people that require healthcare attention. The article focuses on several advantages of the integrated healthcare delivery systems (IDSs) in the United States. Furthermore, the scholars identify existing gaps, which include the various arguments of current health policy experts that have endeavored to discuss health policy issues in America. Americans can also access health care services through virtual technologies, which allow them to have different electronic health record databases. (Hwang, et al. 2013) uses relevant materials from peer reviewed and non-peer reviewed articles to describe the fluctuating nature of healthcare service delivery in America. Conclusively, the authors agree that the virtual systems create room for accountability, academic research in healthcare and efficient service delivery.

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

The Affordable Care Act created a new approach to care which is called the Accountable Care Organization. ACO is a system of doctors and hospitals that share a financial and medical responsibilities. If the ACO is successful in meeting quality and cost savings targets, these organizations qualify for financial incentives or shared saving from Medicare programs. The goal of the ACO is to coordinate

Pioneering an Accountable Care Organization Model which is a program which goes hand in hand with the Medicaid Shared Savings Program. They are focused on providing highly coordinated care for Medicare fee-for-service-beneficiaries.

The concept of an Affordable accountable cCare oOrganization (ACO) is still evolving. Generally, an ACO is a group of health care providers (including primary care physicians, specialists, and medical facilities) that work in partnership and are collectively accountable for the cost and quality of health care they deliver to a specific population of patients. At the heart of each patient's care is a primary care physician.

Accountable care organizations (ACOs) are consist of providers who are jointly held accountable for achieving measured quality improvements and reductions in the rate of spending growth.

The health restructuring dispute has centered on compensating providers particularly more when delivering quality care to their patients than for enhancing the volume of services they provide (Ries, 2014) Accountable care organizations (ACOs) is a single proposed way of altering compensation methods to accomplish this objective by generating encouragement to enhance care coordination and clinical integration (Thygeson, Frosch, and Carman, 2014).

The Accountable Care Collaborative is Health First Colorado’s program that is the primary resource to provide enhanced coordinated care. The three primary goals of the ACC program are to better health, improve the experience of both the providers and the ACC members, and to contain costs. The ACC connects primary care medical providers (PCMPs), the statewide data and analytics contractor (SDAC) and the Regional Care Collaborative Organizations

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).

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 implementation of the Affordable Care Act (ACA), popularly known as “Obamacare”, has drastically altered healthcare in America. The goal of this act was to give Americans access to affordable, high quality insurance while simultaneously decreasing overall healthcare spending. The ACA had intended to maximize health care coverage throughout the United States, but this lofty ambition resulted in staggeringly huge financial and human costs.