ACOs May Change Healthcare for Seniors

Accountable Care Organizations (ACOs) are groups of doctors, hospitals, and other healthcare providers whose goal is to provide better quality care to Medicare patients.  The focus is to reduce the numbers of re-hospitalization and lower the health care costs.

How ACO Groups Work

The plan is to change the measurement system to show the outcomes of care rather than fee-based services. This is a drastic change since most health care providers focus on volume of care over quality.

The ACOs offer providers incentives to prevent readmission to the hospital. One way is to penalize them by giving reduced reimbursements for patient care. According to statistics from 2009, 20% of Medicare patients end up back in the hospital in less than 30 days after being released. This costs Medicare over $17 billion dollars in a year.

Alternative to ACOs

Since hospitals are seen as the most expensive care option, the goal is to transition to the right after-hospital setting. This may be a nursing home, assisted living, or other retirement living home. By providing nursing care in a facility to seniors, it is hoped that the readmission rates will be dropped dramatically.

Hospitals will be looking at senior care facilities to find the right ones to partner with. They will find out who is able to take patients as they are discharged, and who will provide the best care so that patients are not back in the hospital in the next 30 days.

Many healthcare providers are not sure of the implications of the new program and how it will affect them. They are not sure of the risks involved or if they will participate in the program.

It is obvious that better quality care will be beneficial to seniors, but not everyone is certain what will create those results.

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