One of the goals of the Patient Protection and Affordable Care Act was to change the way we deliver healthcare in this country so that we reduce growth in healthcare spending while simultaneously improving the quality of care and the health of the people served. Accountable care organizations (ACOs) were proposed as a way to deliver more effective and cost-efficient care to Medicare beneficiaries. An ACO is a network of service providers and suppliers with shared responsibility for both the cost and quality of care. In theory, if physicians and hospitals work together to coordinate care for patients and to avoid unnecessary tests and procedures, they can reduce healthcare costs while improving the quality of care that patients receive.
ACOs are expanding. A recent report shows that we now have 585 ACOs in the United States compared with 522 in 2014 and 258 in 2013. Nearly 70% of Americans live in regions with access to at least 1 ACO and approximately 11% of the 5.6 million Medicare beneficiaries now receive their care from an ACO.
ACOs are still evolving and developing, but they are reimbursed differently than traditional fee-for-service providers. The higher the quality of care providers deliver, the more shared savings their ACO may potentially earn, provided the ACO also demonstrates lower growth in healthcare expenditures. This offers ACOs an opportunity to eliminate unnecessary services and emphasize preventive measures that may result in better outcomes.
But adopting more efficient, cost-effective ways to deliver care is not enough. ACOs must carefully track data to prove they offer better value for our healthcare dollars. To do so, ACOs will need to adopt, incorporate, and embrace the use of evidence-based medicine. This will focus resources on tests and treatments that work, while reducing the use of ineffective or unproven technologies.
To learn more about the essential elements that ACOs need to be successful, download our complimentary white paper, Accountable Care Organizations: Evidence is Essential for Success.