Accountable Care Organizations Essay
Define ACOs and discuss their impact on the contemporary health care system. How do ACOs drive cost-effectiveness, innovation, and collaboration in the delivery of health care?Accountable Care Organizations Essay
The primary goal of the implementation of the Affordable Care Act was to create value for patients and the entire healthcare system. This is accomplished through value-based outcomes as inspired through giving incentives to hospitals, doctors and other healthcare professionals in coordinating highly efficient clinical care (McWilliams, et al., 2016). When care is effectively delivered with high quality outcomes, healthcare organizations and providers gain eligibility for bonuses. Accountable Care Organizations is one such strategy used to reduce clinical services that are considered to be otherwise unnecessary and expensive. Accountable Care Organizations basically refer to local entities of doctors, other medical professionals and hospitals which voluntarily integrate to provide highly efficient, effective and quality care to Medicare patients. Accountable Care Organizations Essay
Accountable Care Organizations have catalyzed reforms in the delivery and payment system of the US healthcare system which was initially misaligned and fragmented. This model has reversed traditional payment structures that used fee-for-service to promote quantity rather than quality, which contributed to increased healthcare costs (Shortell et al., 2015). However, ACOs have reversed such trends and promoted delivery and payment systems restructures to promote high quality and cost-effective care.
In ACOs, care is highly co-ordinate d among st doctors, specialists, hospitals and other healthcare providers by maintaining consistent communication regarding the care provided to patients. The co-ordination ensures consistent monitoring on service delivery and this helps to prevent the duplication of services (Williams, et al., 2016). As a result, it is even easier to identify some of the potential gaps that exist in care and institute the most appropriate measures where needed. It is also worth mentioning that the payments made are value-driven where quality is emphasized.This explains how ACOs promote collaboration, are cost-effective and innovative.
Reference
McWilliams, J. M., Hatfield, L. A., Chernew, M. E., Landon, B. E., & Schwartz, A. L. (2016). Early performance of accountable care organizations in Medicare. New England Journal of Medicine, 374(24), 2357-2366.
Shortell, S. M., Colla, C. H., Lewis, V. A., Fisher, E., Kessell, E., & Ramsay, P. (2015). Accountable care organizations: The national landscape. Journal of health politics, policy and law, 40(4), 647-668.Accountable Care Organizations Essay
Accountable Care Organizations (ACOs) represent a changing dynamic in the American health care system where providers will increasingly be paid to effectively manage the health of populations rather than based on the volume of services they provide. An ACO is formed when a group of health care providers (physicians, hospitals, non-physician providers, etc.) come together and collectively agree to become responsible for the financial and quality outcomes for a defined population. The changing payment models shift financial risk from payers (such as insurance companies or employers) toward providers. In doing so, providers are strongly incentivized to change how they are delivering care with the goal of decreasing spending while improving quality measures and patient satisfaction. Accountable care models have been adopted by Medicare, state Medicaid plans, and commercial health insurers. These initiatives have led to an increase in the number of ACOs from fewer than 100 to well over 700 in the past five years. ACOs now exist in all 50 states and provide care for more than 23 million people.
The fragmented and misaligned state of the U.S. health care system has become a catalyst for payment and delivery system reforms. Traditional fee-for-service (FFS) payment structures incentivize high volume rather than high quality care, and lead to the sub optimal provision of medical services across the disjointed provider landscape. Despite various attempts to improve care delivery, health care costs continue to rise. The Accountable Care Organization (ACO) model seeks to reverse these trends by promoting a simultaneous restructure of the payment and delivery systems to incentivize higher quality, lower cost care.
This paper provides an overview of the accountable care movement; describes the structural classification of ACOs and various accountable care payment contracts; and provides a high-level trend analysis of where the ACO movement is heading.
An Accountable Care Organization is a system of doctors, hospitals as well as other health care providers who converge and share the obligation of offering exceptional healthcare to patients at reasonable prices. The objective of forming ACOs by the state is to gain more savings on Medicare costs. Majority of the baby boomers in the U.S are about to retire and are probable to obtain medical care as a result of age connected illness. This liability of offering medical care to aging people affects employed individuals as well as the state (Gold, 2011). Hence, ACOs concept was enacted to attempt to lessen the costs of offering medical care. This kind of medical care service is new and as a result the administrative framework that ought to be adopted is not reputable. The law is as well unclear on the leadership system for ACOs. A number of the groups anticipating to operate the ACOs incorporate insurers, doctors as well as health care centers (Gold, 2011). The rule is ambiguous on who ought to manage Accountable Care Organizations, because it was working on making its administration flexible.Accountable Care Organizations Essay
Where Leadership Will Be Needed
The goal of ACOs is to adjust from payment mode that remunerates for huge sum to another one that rewards for worth (Spoerl, 2012). This is projected to meet the goals of an improved prevention of diseases, offering improved patient care experience as well as pulling down cost of health care in case of upsurges. All this is possible whilst ensuring that the corporation is economically stable and flourishing (Spoerl, 2012). In line with CMS, every Accountable Care Organization is anticipated to bear a legal framework that gets and allocates mutual funds impartially amongst all those involved in the Accountable Care Organization. The satisfactorily number of the customers to be served by the ACO need not to go past 5000 participants (AHA, 2010). The ACO need to hire ample number of healthcare experts to take care of all its customers. It needs to accept to be running for a minimum of three years. It need to grow as well as offer ample content on the health experts so as to aid in allocation of beneficiaries as well as in transfer of funds due to shared services (AHA, 2010). Each Accountable Care Organization is anticipated to describe the procedures to practice evidence- based health care, have undertakings to enhance the quality of services whereas the expenses are lessened and offer organized care. Information showing implementation of patient based care is necessary of the Accountable Care Organizations. The administration and guidance of the ACO ought to incorporate clinical and also administrative systems (AHA, 2010).
Clinical leadership and professional leadership will as a result be necessary for Accountable Care Organization to work successfully and meet the mutual funds in Medicare treasuries that makes it a fascinating enterprise. Creating Accountable Care Organizations which have been functioning since the start of January 2012, has not been smooth (AHA, 2010). The procedure has been designated as asset demanding and wastes a lot of time by those working in the sector. Clinical administration will include operation as well as directing of medical experts and healthcare centers as well as the area where medical concerns are demanded. The management part will incorporate the insurance corporations that are linked with Medicare as well as the administration of the assets of the ACO. The management guidance does not require any medical credentials, however they are probable to be successful if focused on business. They will hold the obligation to pursue the associates to be incorporated in the Accountable Care Organization as well as get the beneficiaries offered by ACO.Accountable Care Organizations Essay
Primarily, they will take part in the allocation of mutual funds amongst the members. This disparity between clinical leadership and administrative leadership will make sure that the health care experts focus on offering exceptional care to the beneficiaries, who are assured of well cared funds. The interaction between the two bodies of running the Accountable Care Organization ought to be effective. This will aid in assuring productivity of the entire corporation as well as dealing with issues that any of members have. The managers picked to administrative posts ought to be qualified, versatile and creative so as to lead a company whose blueprint is a fresh idea in the market. There are restricted case studies that will provide a comprehension on how to operate Accountable Care Organizations (Spoerl, 2012).
Skills Needed for Leadership
The two divisions necessary in operation of Accountable Care Organizations need diverse collection of abilities so as to run successfully.Accountable Care Organizations Essay
Clinical Leadership Skills
Clinical leaders will have the obligation of supervising daily operation of health organizations. They as well have to make sure that the quality of the medical services offered is of best standards. These managers are experienced medical experts as well can have trustworthy perceptions on medical exercises undertaken by the ACO (BMA, 2012). Abilities necessary for clinical experts incorporate political and communication skills as well as clinical trustworthiness.
The communication abilities essential for most of clinical leaders is ability to listen well. Majority of experts in the healthcare sector have uttered disappointments for not being listened by their bosses, in line with research (BMA, 2012). Thus, it is essential as a clinical leader to listen exceptionally well to the opinions and verdicts of corresponding medical experts. The capability to think about the guidance as well as the occasional condemnation is a great facet of a great clinical manager. This presents the idea that the manager is set to work with subordinates (BMA, 2012). Health care experts are indeed connected to managers who are prepared to confess in case of errors as well as improve their tactics as required.
Political skills include the capacity of the manager to agree on as well as develop harmony amongst medical associates. Arbitration, coaxing as well as swaying abilities are not incorporated in majority of health care education programs and this makes it challenging for experts to practice. Health experts go for an open consultative tactic (BMA, 2012). This is due to the fact that attempting to unite the opinions of vast self-governing experts mainly all over the areas of hospital medicine is quite challenging. A clinical manager ought to have the capacity to reinforce his trustworthiness by developing backing from associates. They ought to be capable of working in groups as well as be accountable for decisions settled on. Being responsible for the results experienced from the decisions made is a trait of an excellent clinical chief (BMA, 2012).
Clinical leaders ought to hold as well as sustain clinical trustworthiness among coworkers. They ought to have amassed massive know-how, exposure as well as study clinical abilities upon selection as bosses. They ought to uphold clinical duties and depict incomparable devotion to clients given that they hold their management posts (BMA, 2012). Being a supporter of patients’ wellbeing as well as always keeping in touch with patients is most probable to reinforce the status of a clinical leader among subordinates. A successful clinical manager ought to motivate his or her subordinates by displaying good personality. They have to be spirited and hold an emotional resolve when going through stress caused by coworkers (BMA, 2012). They ought to show exceptional passion from their job and the broad health care career. This optimism and zeal is the gateway to aid them deal with challenges. Majority of health experts have a distinctive aspiration to feel more confident in the obligations and this is anticipated from the leaders. Honesty, decency and responsibility for decision settled on by clinical chiefs are the core non-negotiable principles that define them (BMA, 2012).Accountable Care Organizations Essay
Administration leadership skills
A good administration executive ought to be a good listener, ascertain the issues being experienced by the corporation as well as procure possible solutions. Listening makes it easy for employees and customers of a company to be heard as well as clear up their anticipations. Listening without coming up with verdicts makes it easy for the subordinates to trust and treasure their leader (Bairre, 2013). They should be excellent communicators capable of sharing opinions in a simple and neat manner whilst looking at the demands and wishes of the targeted audience. They ought to be candid, optimistic and considerate in their interaction (Bairre, 2013).
Good administrative leaders are exceptional managers who focus beyond the accessible opportunity and offer allowances for occasions that may not be predicted in a short time. They come up with the company’s objectives as well as outline its purposes. They go on and define how they can be accomplished, promising effectiveness of the corporation. It is their duty to motivate as well as inspire their subordinates in the company (Bairre, 2013). This is possible via acknowledging achievements, praising and appreciating their hard work. The leader ought to easily assign tasks to subordinate workers as well as offer them an opportunity to be the best. This presents the subordinate worker a sense of worth and being trusted with the administration whilst giving the leader time for other important obligations. They ought to be able to create a guiding relation with coworkers as well aid them in grasping and learning up-to-date skills (Bairre, 2013). Being advisors, they have the responsibility to infer advancements, guide as well act as role models. The skills and exposure they possess should aid grow other people.
Administrative leaders ought to be at ease with technology and fathom how to make use of diverse systems (Peacock, 2013). These leaders need to have fundamental monetary as well as budgeting abilities and pay attention to the client. In this situation, they ought to be focused on the requirements of beneficiaries as well as apply this in creation of policies in the company. These managers ought to be versatile but not loose. They as well have to display some firmness to avert making decisions carelessly for the company (Peacock, 2013). They ought to offer the corporation a feeling of direction, give an ear depicting humility, and however be brave and not to dread taking risks for development of the corporation.Accountable Care Organizations Essay
Communication Style Required of ACO Leadership
The four communication techniques exercised by people include; passive, passive aggressive, aggressive and assertive communication styles. A passive communicator shuns articulating his or her emotions, ideas as well as perceptions. When communicating, they do so in a remorseful way and as a result others may not pay attention (Roher, n.d.). Other people may probably misuse them and make them feel worried, desperate and confused. They cannot control their lives. They are vulnerable to being stressed frequently. They as well try to hate other people as they hardly get their necessities fulfilled (Roher, n.d.).
Passive-aggressive individuals are deceitful people who do not succeed to handle openly their issues. They seem to have no problems towards other people, but they hold their anger against others. They regularly embrace cynicism, baffling body language as well as rejection. They chiefly attempt to interrupt or demoralize other people (Roher, n.d.). Because of these conducts, many people do not belief them. Aggressive communicators defend themselves, although in the wrong manner. They regularly tamper with the rights of other people and are rude when conversing (Roher, n.d.). This actions are caused by lack of enough authority. These individuals attempt to rule others via control and have an arrogant body language. They are also bad tempered and have sturdy and irritating feeling of authority. Aggressive individuals isolate other people via these conducts as well as feel powerless as they cannot not have their needs satisfied in a great way (Roher, n.d.).Accountable Care Organizations Essay
Assertive communicators are capable of articulating their views in a flawless and decent way. They try to meet their needs without having to infringe or push away the rights of other people. These people are confident and embrace a cool body language as well as a good tone while interacting, they are excellent listeners and utilize strength of their mind (Roher, n.d.). They feel in-charge and others feel comfortable and related to them. These individuals get what they desire thus they have no time to control or overlook other people. These communicators defend themselves, as well as take blame for their mistakes. To successfully meet their obligations, the administration of ACOs is required to adjust with the firm technique of communication. For executives inclined to other techniques of interaction, they ought to improve on specific facets of communication with others to acquire a better style (Roher, n.d.). The passive communicators ought to turn into better communicators by articulating what is their mind regularly. Aggressive communicators ought to articulate themselves in a reliable manner and value other people. The passive aggressive communicator can easily enhance his or her efficiency in interaction by articulating on how to handle difficulties (Roher, n.d.).
Vision and Mission of ACOs
Mission
The mission of an organization is the reason for its existence and it aids in decision making undertaken by the leaders of the company (Goldsmith, 2011). As Accountable Care Organization is an association of medical care providers who focus on offering exceptional healthcare at affordable rates, the mission may be asserted as: “A partnership of health care facilities and physicians dedicated to providing comprehensive, affordable, high quality and sustainable medical care for the patients and community with emphasis in preventive health care”Accountable Care Organizations Essay
Vision
The vision asserts that the reason for the success of the company and provides a roadmap on what the corporation hopes to achieve and what to be in future. By alerting clients on the values of the company as well as conveying to investors and associates on how the company will run, it presents a hope for a bright future (Goldsmith, 2011). A sample of a vision statement of ACO looks like: “to be a leader in the transformation of the existing health care system from volume-based system of value-based one by creating a replicable and affordable framework that results in the best possible health for the community at the lowest possible cost whilst strengthening and preserving the health safety net.”
Values
The ethics of a company are the ideologies workers, shareholders and beneficiaries put up with. Together with the mission as well as the vision, they make the company stand out from its competitors. To certain scope, they determine the company’s organization conduct and culture (Goldsmith, 2011). These values that you will find in an ACO incorporate;
- Enhanced preventive healthcare for the community
- Patient-oriented care
- Incessant development
- Cooperation
- Invention
Goals
Companies have to express their goals so as to accomplish and fulfill their vision and mission. These goals are well-planned, and aid the medical care planner in focusing on those chores that bring changes to the firm (Goldsmith, 2011). Accountable Care Organizations set the following goals and they are the reason why they were communicated;
- Lessening the expense of offering medical care
- Improvement of communication and transparency
- Enhanced access to healthcare
- To boost quality of healthcare
- Enable coordination of healthcare
- Personality Skills Needed Accountable Care Organizations Essay
The character traits of individuals chosen as executives of Accountable Care Organizations are most probable to affect how the firm runs. For instance, communicative executives will be able to share with many doctors as well as be able to sway many other to join hands and build a sturdier Accountable Care Organization. These individuals are also capable of engaging beneficiaries helping the ACO get the necessary least number faster than if not involved in the process. The characters of these individual in the management or leadership group of an ACO ought to be unique, because each has his or her own strong points and flaws (Denham, 2010). The moment the diverse individuals are brought together, they can build a successful management group.
The outgoing persons hold the best abilities and may be used to inspire employees as well as safeguard external undertakings of the firm (Denham, 2010). The shy people are exceptional at analytical abilities and would thus be quite ample to have them run the funds as well as the budget for the firm. They can as well be beneficial when it comes to forecasts and tactical planning. Other characteristics vital for running an ACO are determination, assertiveness, self-consciousness and much more (Denham, 2010).Accountable Care Organizations Essay
As much as assertiveness is a core trait, those in the management group ought to be supportive as well as confident to inspire others. Zeal is essential, as it glows out from these individuals to motivate the rest of the team. These individuals ought to also be well-versed with their abilities, desires and charisma. On top of this, besides understanding their capabilities, they ought to have self-esteem in those skills (Denham, 2010). These personnel should be morally upright, goal-oriented as well as have self-control. At last, they ought to exhibit an ability to survive when they encounter devastating issues.
Conclusion
The above discussion makes it clear that Accountable Care Organizations need to be separated when it comes to management. This is due to the fact that ACOs will have both medical and corporate facets. Each will demand experts from particular areas so as to operate competently. Interaction between the two core groups is necessary for easy operation of the firm.Accountable Care Organizations Essay