Accountable care organizations (ACOs) are an attempt to coordinate care and provide a more unified approach to healthcare for patients. ACOs (similar to health maintenance organizations (HMOs)) are becoming more widespread, as healthcare organizations are beginning to realize that effective healthcare requires less duplication and more coordination across the many different healthcare disciplines. ACO’s also follow this holistic model in order to cut down on healthcare costs, therefore reducing wasted resources.
Accountable Care Organizations
Accountable care organizations (ACOs) saw their origins in the 1970’s, when Health maintenance organizations (HMOs) saw their beginning (Sullivan, 2010). ACOs are modeled after HMOs, with there being some subtle differences between the two. The label ACO was invented in 2006, at a public meeting for a Medicare commission (Sullivan, 2010).
Structure of the ACO
An ACO is made up of groups of healthcare providers (physicians, surgeons, nurses, paramedics, etc.) and hospitals (Accountable Care Organizations (ACO), 2015). These groups of healthcare providers and healthcare facilities aim to provide a patient (or, more commonly, patients) with a unified and coordinated approach to their healthcare and their wellbeing (Accountable Care Organizations (ACO), 2015). This is done to ensure that procedures and actions are not needlessly repeated, in an effort to drive down overall healthcare costs and reduce the chances of errors occurring medically (or at least it is an attempt to do all of this) (Accountable Care Organizations (ACO), 2015). Medicare also provides programs for ACOs as a way to attract people to adopt that model of healthcare (Accountable Care Organizations (ACO), 2015).
Differences between HMOs and ACOs
While the ACO does see its origins in the HMO, and they share many similar features, there are some subtle differences between the two. HMOs, like ACOs, attempt to coordinate care for a patient through many different parties and providers. Both models attempt this in order to drive down healthcare costs by reducing duplicated services and eliminating medical errors (Accountable Care Organizations (ACO), 2015), (Sullivan, 2010). However, ACOs allow their patients to journey outside of their network, while HMOs do not (Gold, 2011). The HMO’s ran into problems when consumers left HMOs, as they despised the restriction that a HMO had on their healthcare (Gold, 2011). ACOs attempt to avoid that similar situation by following the same guided practice pattern that HMOs have, but by also allowing their patients to utilize services and providers that are not involved in that ACO (Gold, 2011).
Future of ACOs
The future of ACOs looks bright. The ACO attempts to provide what makes HMOs so attractive on paper, and then going a step further and fixing particular deal-breaking issues (such as the HMOs restriction on going outside of the network) (Gold, 2011). ACOs are becoming a popular subject, with many hospitals and healthcare providers adopting the model (Gold, 2011).
ACOs are a valiant attempt to cut-down on medical costs and to reduce errors in a patient’s healthcare by adopting a unified and coordinated approach to healthcare. ACO’s future looks bright, as the model makes sense and with the attempt to reduce healthcare costs comes the introduction of Medicare programs that bring extra money in (Accountable Care Organizations (ACO), 2015).
- Accountable Care Organizations (ACO). (2015). Retrieved from cms.gov: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ACO/index.html?redirect=/aco
- Gold, J. (2011, January 18). Accountable Care Organizations, Explained. Retrieved from npr.org: http://www.npr.org/2011/04/01/132937232/accountable-care-organizations-explained
- Sullivan, K. (2010, October). The History and Definition of the “Accountable Care Organization”. Retrieved August 26, 2015