What do Accountable Care Organizations (ACOs) mean to U.S. Patients?

No one would disagree that better quality of service for less cost is highly desirable in any industry.  It seems the Healthcare Delivery Industry has, for a long time, been “behind the times”.

Sparked by the incentives of the Affordable Care Act (ACA), a new and innovative approach to Healthcare Delivery, the Accountable Care Organization (ACO) has come into the forefront of patient care models.  ACOs are groups of primary care physicians, specialists, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to the patients they serve.

The basis of the ACO model can be represented with this acronym: PEACE

·         Prevention of Illness and Disease

·         Evidence-based Treatment

·         Access to Care Resources

·         Coordinated Medical Care Team

·         Electronic Health Records 

We can look at each of these points and explore the how and why the ACO model may provide a great start towards improving the Healthcare Delivery System in America. 

Prevention of Illness and Disease - The best way to control health care costs is to stay healthy. Reducing readmissions and hospitalizations for preventable conditions alone could save the Medicare program at least $12 billion per year. It is estimated 50% of Americans don’t get the recommended preventive care and screening tests that science recommends.  ACOs believe in wellness and preventive care. You get reminders for the tests, screenings, and immunizations you need, and health information, classes, and advice are easily available.

Evidence-Based Treatment - Scientific advancements are so rapid that no single physician can stay on top of all the current and best treatment options. ACOs support their patients and doctors by providing information about up-to-date treatments based on research and evidence.

Access to Care Resources - Significant numbers of Americans don’t get the recommended health counseling and education for their conditions.  Providing the right care at the right time is the goal of ACOs. Patients of ACOs are able to get professional medical advice day or night, in offices, by phone, and even via e-mail. Quick treatment helps maintain health and reduces cost.

Coordinated Medical Care Team - It is estimated that unnecessary care or “overtreatment” kills 30,000 Americans a year.  Care teams and care coordination are very important when you need to see more than one doctor, or you need to be hospitalized. In the ACO model, coordinating your care among all your care providers ensures that each knows what the other is doing for you.

Electronic Health Records - The Institute of Medicine (IOM) has estimated that 44,000 to 99,000 patients die in hospitals each year due to medical errors and that there could be at least 1.5 million preventable adverse drug events in the U.S. every year.  A high percentage of U.S. patients have reported that medical records and test results were not available during a visit or that tests were duplicated unnecessarily.   Shared electronic medical records help both your primary care doctor and specialists know your entire health history, the drugs you have been prescribed, and your test results. This improves the cost, quality and safety of the care you receive.

These five principles are shared by Accountable Care providers who take responsibility for the cost and quality of the care they provide to their patients.   Patients receive better care at a lower cost and have a greater PEACE of mind.