Healthcare Real Estate Developer|Rebuilding the Reimbursement Model
As the Keynote speaker at last month’s Interface Medical Office Conference in Dallas and the cover of the August edition of U.S News and World Report suggest, Accountable Care Organizations (ACOs) are rapidly growing in popularity among health systems. ACO’s, in the mind of the architects of Health Reform, will become the Keystone to control the floodgates of future patients into the healthcare system.
An Accountable Care Organization is a type of health system in which a hospital and/or large physician group practice are held accountable for the continuum of health for patients in the community. Instead of receiving a fee for service, like the current pay model, ACO’s receive a flat fee per patient from the patient’s insurer or employer for a sequence of services.
Accountable Care Organizations accomplish two primary objectives:
Increase Physician Communication.
Typically physicians of different disciplines lack quality communication via the current standard. While a patient may see several specialists, the process is difficult to combine their efforts effectively for the patient’s best interest. A patient’s primary care physician may not be aware of the qualitative and quantitative tests and procedures during a patient’s extended time of care. The Accountable Care Organization model redefines and better coordinates physician communication by maximizing the benefits of electronic health records, linking and organizing the practice of collective treatment.
The goal of the ACO is to reduce inpatient stay. This may seem contrary to traditional hospital philosophy; however, with the current readmission rules regarding Medicare reimbursement, the strategy proves to be cost efficient. The previous method of generating revenue from inpatient procedures and tests has been reevaluated. Physicians salaried by the hospital, a relationship indicative of the ACO model, are de-incentivized to extend inpatient stay.
Hospital systems implementing this design such as Montefiore Medical Center in New York and Geisinger Health System in Pennsylvania have already noticed a decrease in readmissions.
Accountable Care Organizations proposes to change the model for the delivery of healthcare. The acquisition and development of multiple outpatient clinics in a hospital’s community area will be the chosen application to better service the hospital’s community. With more clinics, healthcare systems can better cater to patients’ needs in an efficient and cost effective manner.
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