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This past week I was in the DC area talking to physicians about patient-centered Medical Homes and Accountable Care Organizations (ACO’s). Much of the conversation revolved around Medicare and Medicaid plans and patients. As we were talking about opportunities for the future the conversation turned toward working directly with companies in setting up ACOs.
The idea of an ACO makes sense when you think about it as the goal is to deliver the best healthcare possible to avoid costly problems later. Just as the best ballplayers make the most money, and the best CEOs get the biggest bonuses the idea is that the clinicians and practices that provide the best results will get the best reimbursement. This idea is gaining a lot of traction in the business world as companies as large as Intel have added these to their offerings, and Humana, Cigna and UnitedHealth Group are making these plans available to their employer accounts.
As a prescriber you can expect to benefit from increased reimbursement for better outcomes as your patients reach targeted goals, such as cholesterol lowering or improved A1c’s.
This extra incentive can mean increased opportunities for other medical professionals as well. Pharmacists will find opportunities managing drug therapy, adherence, persistence, and interactions, and educators, social workers and health coaches will be brought in to insure better outcomes.
Armed with data from a JAMA study that lasted for 8 years, this idea of coordinated care cut medical costs by 5-10% and significantly lowered hospital admissions.
To learn more about ACOs, and how you might benefit check out AAPF.org or the NCQA website.
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Dave Joffe, Editor-in-chief