One of the central tenets of President Obama’s Patient Protection and Affordable Care Act is accountable care organizations (ACOs). These organizations will comprise various healthcare providers who will coordinate their patient care in an effort to improve quality and lower costs. They’re starting to appear as healthcare systems test the ACO concept and how it will work when it most likely will become federally mandated in 2014.
As the first ACOs get off the ground, they have implications that may begin to affect healthcare systems now, long before the 2014 deadline.
One of the most important is the possibility that the incentive models at the heart of the ACOs can reduce hospital usage. In response, many hospital systems are setting up networks now that are structured much like an ACO, so patient care can be funneled toward ambulatory locations when appropriate. Hospitals can then be staffed and run to provide more efficiency in their acute levels of care.
Another outcome to be prepared for: If healthcare coverage is expanded in 2014 as planned, the healthcare providers who will be most successful are those who can identify potential patients, down to the household, who don’t currently have coverage — but will have coverage as a result of the Patient Protection and Affordable Care Act.
Rather than being forced into a reactionary mode, healthcare systems who plan proactively will be able to adequately restructure and staff their facilities to handle significant increases in patient volume.
Our conclusion? Even if the government’s ACO mandate doesn’t materialize exactly as expected, anticipating the changes that some form of ACO-style network will demand across the country is a very smart way for healthcare systems to start maximizing services for the future.