Research, Define And Describe Accountable Care Organizations (ACO)

Accountable Care Organization
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Research, define and describe Accountable Care Organizations (ACO).
An Accountable Care Organization (ACO) is an association of healthcare providers, healthcare institutions and insurers whereby all parties voluntarily undertake medical and financial responsibilities for Medicare patients (Bard, & Nugent, 2011). An ACO fosters coordination of care that leads to patients receiving the necessary care at the right time while minimizing the risk of clinical prone errors and unnecessary health services.
ACOs focus on organizing and aligning care services to providing highly coordinated and efficient care whether the organization is contained within one corporate structure or is based within an organized network of different but connected health care practitioners (Bard, & Nugent, 2011). This enterprise alters how health care professionals are paid instead of being paid for every service.
ACO payment model(s).
Advance Payment ACO Model
This model is mainly created for physician-based and rural medical providers that have collaborated to voluntarily deliver a seamless, high-quality and well-coordinated care to all the Medicare patients under their care (Kinney, 2015). Through this payment model, the selected caregivers receive monthly and upfront payments that they can utilize in investing in proper infrastructure for care coordination.
Pioneer ACO Model
This payment model is designed for healthcare institutions and health care professionals that already engage in care coordination for patients across all care settings (Harris et al., 2010). Through the Pioneer ACO Model, these provider groups can move faster from a shared savings payment model to a population-based payment scheme which is highly consistent but independent from a Medicare Shared Services Model.
Medicare Shared Savings Payment Model
This payment scheme focuses on coordination and cooperation among healthcare providers in the enhancement of care for Medicare Fee-For-Service (FFS) beneficiaries and also the reduction of unnecessary expenses. Eligible providers, health institutions and suppliers can create or become involved with an Accountable Care Organization (Harris et al., 2010). This model, therefore, fosters accountability of care for all the beneficiaries. It also requires that all services which are provided are highly coordinated. This payment model encourages investments in infrastructure and redevelopment of the care procedures.
Why Population Health is important to an ACO
Population Health is essential to an ACO as it allows the organization to proactively address the needs of all individuals of the population, both less-active and disengaged individuals that may not have access to the necessary care (Kinney, 2015). Focusing on the patient population allow the ACO to provide the best-coordinated care. This fosters physician engagement, as all medical professionals and other parties involved in the ACO can provide informed services that may not have been delivered within the continuum of care.
Through analyzing various health populations, medical professionals in all care settings become aware of the patient's risks for a condition that may harm ...