Term Paper on "Accountable Care Organization"

Term Paper 5 pages (1629 words) Sources: 0

[EXCERPT] . . . .

Accountable care organizations are networks of doctors and hospitals that work together so that patients can have coordinated care. Organizations that do that must agree to take on Medicare patients for a specific period of time, and they have to agree to be responsible for those patients and to work with one another so that they can give the patients proper care. not all doctors and hospitals want to do that, because they often feel as though they are "locked in" too much when it comes to agreeing to take on Medicare patients, or to be responsible for them for the next three years.

Studying accountable care organizations provides a wealth of information for anyone who is interested in how doctors and hospitals interact. That was the main goal of the team project and presentation - to discover how hospitals and doctors work together and what they can do to help their patients when they really get together and get focused on taking care of their patients first. Too often, doctors and hospitals focus on the bottom dollar, or they get stuck in all of the rules, regulations, and guidelines that they must follow - and they forget to focus on their patients first.

There are several conclusions that can be drawn when it comes to accountable care organizations. The first of these conclusions drawn by the team is that quality measures are both important and necessary from the hospital's point-of-view so that costs can be saved. Contrary to popular belief, lower quality does not always mean lower cost. Often, hospitals and doctors end up spending more on their patients when they do not take proper care of them. The proper implementation of quality care methods that are used across the board is vital to meeting the needs of patients and keeping the costs down to a level that is considered reasonable in hospitals and doctors' offices.

Health care costs are already very high, and there are often no easy ways to quickly lower them. However, when hospitals and doctors work together, patients can get better care that does not cost any more than necessary. The reason that this works so well is that the patients are able to be treated by their doctor and they do not need repeat tests at the hospital. That saves a lot of money and allows patients to get good quality care without asking them to spend extra money - or asking their insurance company to foot the bill - on tests that they might not need or might have already had.

The second conclusion is that duplicate and incorrect tests need to be eliminated and inadequate treatments need to be avoided as they relate to measures of quality. While this is an obvious, common sense type of issue, inadequate treatments and duplicate tests are really very common in the health care field today. Duplicate tests cost money, and so do incorrect tests. With the duplicate tests, the costs go up and so does the frustration of the patient who already took a particular test and now has to take it again for a different doctor or different hospital. For incorrect tests, the costs are an issue but the patient is also put through upset and worry that he or she would like to avoid.

These tests will not usually find anything, because they have nothing to do with the symptoms with which the patient presents. Because of that, the tests are simply a waste of time and they need to be avoided. They cost patients and they cost insurance companies, which contributes to the skyrocketing health care costs that are seen in hospitals and doctors' offices today. There are certainly other reasons why health care costs are rising, but incorrect and unnecessary tests that cost patients and insurance companies money are a large and avoidable part of the problem.

The third conclusion is that, when compared with in-patient worst-case scenarios, having accountable care organizations helps to lower costs and prevent problems with patients. Worst-case scenarios include misdiagnosis of a serious and/or life-threatening illness, the death of a patient when that death was highly preventable, serious medication errors, and similar problems. Unfortunately, these kinds of things happen more often than one would assume if one did not work in a medical setting. Naturally, most patients do not experience these worst-case scenarios and are treated effectively - even if they are really not treated efficiently. When accountable care organizations are used, though, they help to make doctors and hospitals more accountable to the point that problems with patients are more easily prevented. Health care costs are also lowered by these organizations, because patients do not have so many repeat tests and unnecessary tests and procedures.

Lowering costs is certainly important, but preventing problems with patients is of the utmost concern. Patients can die when doctors and hospitals make mistakes. While that can never be completely eliminated, the goal is to lower the number of times something like that happens to as small of a percentage as possible. Doctors and hospitals that are part of accountable care organizations really are more accountable to others for their actions - and for their mistakes. Because they agree to take care of patients for a specific length of time, they help those who are on Medicare live healthier lives. Many of these people have a number of health problems, and doctors and hospitals see these patients often in the majority of cases. By spending time with their patients and committing to them, the hospitals and the doctors can make sure that the patients are getting the best possible care.

The fourth and final conclusion is that there are many potential benefits to providers and hospitals, as well as patients and the entire population that may need medical care. Benefits include better control of quality and patient care, as well as lowered costs. Patients who are being treated under an accountable care organization also find that they are simply treated better than patients who are not part of one of these organizations. Because that is the case, patients can have peace of mind. Insurance companies also like these accountable care organizations, because they keep costs lower and they do not spend time billing the insurance company for repeated and unnecessary procedures. Medicare is the insurance used by the majority of patients who are treated by doctors who are part of these organizations. It is important for these patients to get good care, but it is also important to treat them in such a way as to avoid raising health care rates for everyone else.

Hospitals and doctors can also benefit from the accountable care organization if they choose to be a part of it. The way in which they benefit is through lowered costs and less stress when it comes to working with patients. When doctors and hospitals work closely together, they eliminate a lot of extra work that would otherwise have to be done, and they can collaborate on the needs of various patients. By sharing medical records and patient information, patients can be treated more quickly and efficiently when they go to their doctor or head to the hospital. The hospital or doctor can avoid giving the patient unneeded medications or tests, because the records clearly show that the patient either does not need those things, has already tried them, or cannot have them for some specific reason. Accountable care organizations help everyone that is involved with them, not just patients and not just doctors. More doctors and hospitals should get involved with these organizations in an effort to help patients and to help themselves operate more efficiently.

As can be seen, the team addressed the project in such a way that many good conclusions could be drawn.… READ MORE

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