Accountable Care Organizations  Research Paper

Accountable Care Organizations  Research Paper

Instructions/Descriptions

Accountable Care Organizations  Research Paper

Executive Summary of ACO

Accountable Care Organizations are a silent moving entity that has rather quietly entered and begun changing the health care landscape. These organizations are highly useful and practical for individuals who is particularly interested in investing in the Medicare population. With organizations with long term care that has a sizeable Medicare population they need Accountable Care Organizations. With this paper I am going to provide examples of what the organization offers, what Accountable Care Organizaations are and provides. This paper is also going to explain why it is important for organizations to participate and how ACO can allow participation easier for the organization.

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Long Term Care Facility

As an organization, our specialty is in long term care. We have several facilities that simultaneously offer skilled nursing care and assisted living care. Our populations are made of senior citizens in varying stages of personal and health care needs. Medicare covers a large number of patients. Medicare Part A covers our patients in skilled nursing for their daily care, and it covers the actual nursing care of some of our patients within the assisted living care side of the facility.

Medicare Part A also includes our patients using Hospice, and it is used for any of our patients who are discharged to the hospital for their hospital care, Medicare Part B is used to cover any ambulance service our patients may need including ambulance care to the hospital. A large number of our patients’ prescription drugs are covered through Medicare Part D through pharmacies contracted with our facilities and Medicare to provide medications.

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Overall a vast majority of our patients use some form of Medicare during their stay at the facility, making our company interaction with Medicare crucial to the success of our company and for the continuum of care for our patients (Goodwin, Dixon, Anderson & Wodchis, 2014).

Types of ACO

ACOs have become a facet of health care that many people recognize. These organizations are yet another step in the attempt to improve the maintaining of patient health through efficient, high-quality care and readily available access in a cost-efficient manner. There are several ACO organizations all across the United States. All these firms are falling under particular forms of ACO. The types of ACO’s incorporate shared savings programs, the model of the next generation, alongside the model of comprehensive care for ESRD. Some models are extensions of a larger model.

The Investment model and Advance Payment Model are options in the Shared Savings Model (Paraskevopoulos et al., 2017). Participation in the Shared Savings model does not demand participation in the extensions; it is merely an option available at the discretion of the participating organization.

Industry Dynamics

The long term care industry is a booming industry and one that has grown extensively in the last ten years. Part of the reason for this was the aging of the baby boomer generation creating a large group of seniors when it comes to lasting care within the facility. The other purpose is in support of the many benefits of long term care and the many incentives for those looking to enter the industry. These reasons for the growing and booming a lasting facility have also affected creating a competitive atmosphere within a long term care facility (Song, 2014).

The competition within the industry has made it essential that participators in long term care go above and beyond to stand out and make it so that their services are the sought after services. To stay ahead of the competition, a long term care facility needs to provide access and availability by providing superior service and mediation availability, engaging patients and their families in the care process, and providing the overall highest level of care. It is critical that in doing all these things, the organization does so in a cost-effective manner while also staying compliant with federal and state rules, and this includes keeping up to date with Medicare regulations. Staying Medicare compliant can be very time consuming and challenging in current times but has unprecedented importance due to the number of patients in service who use Medicare and the multitude of services we provided that are covered by Medicare (Song, 2014).

ACO Participation

One fortunate point is that Medicare does make participating in an ACO a relatively simple overall process. By going on to the Medicare website, you can see all of the different types of ACO’s, the desired or most amenable model for the organization can be selected to review and a link to the application to participate in the ACO and timeline for the overall process is provided.

Studying the application and deadline offers a thorough guide as to what is needed to complete the form along with a set of steps that will be gone through before participation is granted and starts and what the timeline looks like for getting through the steps and beginning a partnership. There is even a section for renewal so that once participating when it is time to renew participation, and those steps care to be provided for the organization to guide the company through the renewal process as well to continue partnership (Song, 2014).

Reason towards Participation

ACO’s are becoming game changers in health care. The region in which ACO’s operate, which is pretty much everywhere at this point, is siphoning the providers and patients. The high-quality care with lower cost and vastly better patient satisfaction that is accompanying ACO adoption is attracting the attention of organizations and payers all over the country. This shift to ACO’s provides opportunities that can are not be overlooked.

Mainly for long term care facilities, this pathway for cost-effective, high-quality continuum-wide care is a benefit of extraordinary means in the competitive market. For organizations that wish to stay competitive and relevant and be part of the market tomorrow and stay ahead of the game, this is a necessary move (Song, 2014). Companies that fail to see the changing landscape in health care, companies who refuse to transition with the times or only halfheartedly commit to that transition, will stand no real chance at success.

Conclusion

Just like a permanent care establishment offering skilled nursing care as well as assisted living nursing care, the organization has a large number of patients relying on Medicare for payment of these services. ACO’s help to ensure high-quality, cost-effective, accessible care and coverage for patients creating increased patient satisfaction. In a competitive market where staying ahead is critical, participating in a health care game changer like an ACO is essential for the organization.

References

Goodwin, N., Dixon, A., Anderson, G., & Wodchis, W. (2014). Providing integrated care for older people with complex needs: lessons from seven international case studies. London: King’s Fund.

Paraskevopoulos, D. C., Laporte, G., Repoussis, P. P., & Tarantilis, C. D. (2017). Resource-constrained routing and scheduling: Review and research prospects. European Journal of Operational Research, 263(3), 737-754.

Song, Z. (2014). Accountable Care Organizations in the U.S. Health Care System. PubMed Central: National Library of Medicine, 21(8), 364.

Accountable Care Organizations  Research Paper

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