Vol XVIII: Ch. 6: Care Coordination Models in Accountable Care Organizations
From the Book: The Refractive Thinker® Vol XVIII: Project Management: Strategies to Enhance Workflow and Productivity


Summary

The Patient Protection and Affordable Care Act (ACA) introduced accountable care organizations (ACOs) as a promising model for enhancing population health, improving patient care, and reducing unnecessary costs through collaboration and coordination among independent providers. ACO concept envisions a transformation in the way health care is organized across the continuum. It represents a rational system of care financing and delivery that unites purchasers, payers, providers, and patients in a system that can evolve and improve. Project management approaches for coordination within each and between ACO member organizations have been key for the ACO model success. Through participation in an ACO, independent physician practices gain access to customizable care management services and tools, innovations, and better reimbursement payments. Care historically has been fragmented, but now managers are strengthening coordination because of payment changes that reward coordinated care. The changes include adjustments in processes of care, new reporting systems, staff competencies, cultural change, and analytics. ACOs improve with experience; and the longer they participate in the program, the more likely they to manage costs effectively and earn shared savings. Given the continued need to improve the healthcare system and uncertainty around health policy, care coordination models that support the transition from volume to value such as in ACOs will likely be continue to be important for future policy agendas.

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