The Patient Protection And Affordable Care Act

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With the current implementation of the Patient Protection and Affordable Care Act (PPACA) and Medicare’s performance-based payment incentives, a streamlined model to help improve patient outcomes and decrease healthcare costs must be developed for the perioperative setting (Berwick et al 2012). Established in 2010 by the PPACA, Accountable Care Organizations (ACOs) hold multiple providers accountable for achieving high quality of care and reducing the cost per capita when they are directly involved in providing services for a designated patient population within an integrated system (Kash et al 2014; Ferrari et al 2015). In order to comply with these ACO requirements, the anesthesiologist must be involved in the coordination of the…show more content…
Furthermore, the cost of the current practice accounts for a substantial portion of the inpatient health-care expenses that can be reduced if cost-saving actions are put into place (Sathiyakumar et al 2014; Okike et al 2014; Centers for Medicare and Medicaid Services 2013]. The PSH model attempts to correct the current standard of care by focusing on three tenets: 1) improve clinical outcomes through standardized best practices, 2) increase patient-centeredness and experience 3) decrease the perioperative costs (Garson et al 2014; Prielipp et al 2015; Kain et al 2015; Kain et al 2014; Vetter et al 2013). There have been previous initiatives to improve perioperative care and reduce costs, but most have focused on reducing the patient’s length of stay (LOS) (Eskicioglu et al 2009). For example, Enhanced Recovery After Surgery (ERAS) programs utilize standardized perioperative care in order to accelerate recovery and reduce complication rates (Eskicioglu et al 2009). Although the ERAS programs have shown increased cost-effectiveness and reduced complications rates when compared to the traditional perioperative setting, there still is a need to provide a better continuity of care across the perioperative timeline (Eskicioglu et al 2009; Leee et al 2014). The PSH has been
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