Affordable Care Act and Accountable Care Organizations
Introduction
Establishment of Accountable Care Organizations (ACOs) has remained a major component of the Affordable Care Act since the ACOs form the primary part of implementing the Affordable Care Act. Reflectively, the ACOs are aimed at promoting accountability as part of the health reforms inspired by the Affordable Care Act. Thus, this analytical treatise attempts to explicitly identify the essential components of ACOs. Besides, the treatise presents a summary of what is required by health care organizations to comply with the requirements of ACOs. In addition, the paper identifies and discusses organizational changes that may be necessary to comply with ACOs.
Essential components of ACOs
The main components of ACOs include quality, patient-centered care, care coordination, accountability, innovation, leadership development, and physician self-governance. Under the component of quality, ACOs strive to better care of patients through a series of measures and reports on service and clinical elements of care. The findings are applied within measurement tools such as benchmarking to assure quality in health service delivery. On the element of patient-centered care, ACOs endeavor to ensure that information between patients and physicians are timely shared to enable active participation in customized care (Borkowski, 2009).
The component of care coordination encompasses an electronic medical record to enable the physicians to track and give accurate interventions. Accountability component encompasses being answerable to the costs and quality of care given to patients by a physician and the whole system. Innovation as a component of ACOs promotes flexibility and thoroughness in embracing the constantly evolving models of delivering health care, such as infrastructure and research (American Medical Group Association, 2013).
The aspect of leadership development revolves around building a supportive environment for physician practice and promoting practices that encourage professionalism and enhancement of skills. The last component of ACOs is the physician’s self-governance, which functions on the premise of rationale in decision making, especially on the part of a physician providing or supervising the health care delivery process (American Medical Group Association, 2013).
Requirements of health care organizations to comply with ACOs
The first requirement is that health care organizations must have proper scope and create a vigilant system of managing costs to ensure efficiency in health care service delivery. Thus, the ability to save and minimize avoidable costs in health care delivery forms a vital part of compliance with ACOs in a health care organization. Basically, the health care organization has to “vigilantly manage its costs” (American Medical Group Association, 2013, par. 2).
The second requirement is establishment of relevant and practical clinical analytics within a medical care organization. There should be an intelligent and robust system in place to comply with the ACOs. This system ensures that the records of patients and diagnoses are well documented for timely intervention and treatment without any confusion since the Affordable Care Act targets many patients. A sophisticated system of sharing medical data will not only create an environment of efficiency, but also an environment of quality medical service delivery. Besides, this “will help organizations identify high-risk patients and gaps in care, and redefine care processes while helping improve the care decision-making process” (American Medical Group Association, 2013, par. 4). As a result, a health care organization will be in a position to track the component of care coordination as part of the ACOs.
The third requirement is possession of an apt methodology of communication and sharing of the savings. In order to comply with the ACOs standards, a health care organization should have a strategic savings plan that represents the stakeholders’ and partners’ interests. Thus, successful health care organizations “will be the ones that put significant thought into the specifics of shared savings distributions, and that take the time to modify and update sharing plans as often as necessary” (Spoerl, 2012, par. 2). This requirement addresses the component of accountability in the ACOs.
Organizational changes to ensure compliance with ACOs
The first organizational change to comply with ACOs is the infrastructure transformation. There is need to conduct a proactive assessment of the entire infrastructure such as “electronic medical records, patient registries, electronic prescribing, secure electronic communication with patients, and electronic claims submission” (Spoerl, 2012, par. 4). Besides, the infrastructure should be modified to secure data sharing and continuously manage the quality assurance strategies. In addition, structural modification is aimed at improving the general coordination between care plan and the other stakeholders implementing the Affordable Care Act. When the change is properly carried out, the previous security gaps will be sealed to ensure compliance with ACOs (Borkowski, 2009).
The second change to comply with ACOs is the management approach adjustment. Change of the management approach revolves around establishing a stable rationale for leadership and decision making with a health care organization. It is necessary to remodel management strategies with the need for efficiency, low risk, and proactive process of service delivery. The proposed change of management approach may provide the bridge for coordination of any health care plan with quality assurance needs. When successfully implemented, compliance with ACOs is assured since operational and technical elements of management will be balanced (Parkes and Simpson, 2007).
References
American Medical Group Association. (2013). Accountable Care Organizations: Principles. Web.
Borkowski, N. (2009). Organizational behavior in health care (2nd ed.). New York, NY: Jones & Bartlett Publishers.
Parkes, S., & Simpson, R. (2007). Classic reading in organizational behavior (4th ed.). London, UK: Wadsworth.
Spoerl, B. (2012). 3 most essential elements of a successful ACO. Web.