Given the implications of health care reform, particularly with accountable care organizations (ACO’s)
Should the industry expect to see more strategic alliances being formed with hospital, nursing homes, and physician groups?
The ACO were formed with the aims of improving patient care outcomes as the primary care physicians, specialists, and hospitals collectively collaborate and account for the cost and quality of healthcare provided to the patients. With the current and continuing healthcare reforms, the healthcare is set to see more collaborations as the healthcare providers come together to realize her organizational bottom-line and provide quality care. For exempt, the Affordable Care Act’s reform s one of the underlying driver for future collaboration, and strategic alliances in line with accountable care. The Medicare fee-for-service system further incentivizes the healthcare providers with the “shared savings program. The government through the Centers for Medicare and Medicaid Services (CMS) , there was also a new repress release Notice of Proposed Rulemaking (NPRM) affecting the Medicare ACO program which makes it more profitable to be an ACO/. Additionally, the healthcare providers are increasingly assuming different levels of risk including upside arrangements to partial or complete capitates payment models. Therefore, more alliances should be expected amongst the hospital, nursing homes, and physician groups (McClellan, et al, 2014).
Will alliances promote innovation in delivery of care for higher quality of care?
Some of the latest achievement of the ACO program is the innovative Pioneer ACO Model that has is driven mainly by the desire to improve the quality of care. For example, this is a population-based payment model separate from Medicare Shared Services Program developed to help the private players benefit from the provider incentives to improve quality as well as health outcomes for all the patients visiting the ACO. The Pioneer ACO Model provides efficiency and cuts savings to the participating ACOs. Shortell, Casalino, &, Fisher, (2010, p. 46–71) also argued that it is also important to note that the main challenges faced by the ACO program is transition to more person-based payments and ACO advocates for a fully integrated delivery system. This helps improve quality care by providing personalized care to the paying patient
McClellan M, White R, Mostashari F, &, Kocot L, (2014). Health Policy Issue Brief: How to Improve the Medicare Accountable Care Organization (ACO) Program. The Brookings Institution
Shortell S, Casalino L, &, Fisher E, (2010). Achieving the vision: structural change. Partners in health: how physicians and hospitals can be accountable together. San Francisco (CA): Jossey-Bass; 2010. p. 46–71.