07-u5-t-1-2: Accountable Care Organizations Improve Quality of Care

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Health Policies and Organizational Structures and the Effects of Quality Improvement within Healthcare Environments

Hospitals play critical roles in the provision of health care. They have historically been viewed as the hub of the healthcare system. Few consumers can actually cover the cost of hospital care. Hospitals that serve financially vulnerable populations who cannot afford to pay for care have to rely on insurance: Medicaid, Medicare, Workers’ Compensation or No-Fault. This puts the hospitals in the position of vulnerability, because they cannot rely on other sources of funding. There has been a movement to make the delivery of healthcare in the hospital more competitive by improving the effectiveness and the efficiency of the healthcare system. One way to do this is for hospitals to reorganize and work together, versus standalone competitors. The Affordable Care Act will impact the way hospitals function. Increasing cost is driving the need for change.

The Affordable Care Act has incentives to organize Accountable Care Organizations (ACO’s). These ACO’s are groups of providers and hospitals that develop an integrated model of healthcare delivery. Providers who previously operated independently can develop mechanisms so the patients can receive comprehensive care.

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Topic1: Accountable Care Organizations Improve Quality of Care

How can the formation of Accountable Care Organizations improve quality of care and make providers more responsible for cost of care? Give an example of a study that has addressed coordination of care and has had documented success. Describe the study and its implications for care.