ACOs Changing Immensely by NEW PPACA Law

The Patient Protection and Affordable Care Act which was passed earlier this year has set off a firestorm of activity both within the healthcare sector and among those who serve it. Whenever this new law is fully implemented and however it is refined over the next few years, one thing is certain – the healthcare landscape will differ vastly from what it was at the start of 2010. One important aspect of the new law is the Accountable Care Organization (ACO) for Medicare reimbursement.

What is an Accountable Care Organization (ACO)? It is an organized group of healthcare providers accountable for the overall health of a population of Medicare beneficiaries. One of the central ideas behind the formation of ACOs in the new law is that a reimbursement for overall treatment of a given condition will have a set aggregate reimbursement level, and savings relative to this total amount will be distributed to the participating providers within the ACO. Under the Affordable Care Act, Medicare beneficiaries will be assigned to an ACO based on their primary care physician.

In early November the American Medical Association’s House of Delegates adopted new principles for ACOs at their Interim Meeting in San Diego. These principles begin by stating that the goals of an ACO are to increase access to care, improve the quality of care and ensure the efficient delivery of care. The principles go on to describe governance and the need for physician leadership and collaboration to ensure that a patient’s best interests are kept as the central focus of the care delivered. They also emphasize the need for voluntary participation in ACOs by both patients and physicians.

There is currently a flurry of activity around ACOs – their definition and their formation – and one of the only certainties about ACOs at this point is that information technology will play a critical role in making them a reality. As different providers line up to form ACOs under the Affordable Care Act they will need to effectively share patient information as well as care guidelines to ensure consistency and the best outcomes. Policies, procedures, protocols, guidelines and other important clinical documents will need to be shared not only within a facility, but across the landscape at all the points of care within the ACO. When considering an IT document management solution, keep in mind that it should deliver on the following elements:

• Multi-platform accessibility (e.g. desktops, laptops, tablets, handhelds, etc.)
• Easy, quick document retrieval for the caregiver at their computer knowledge level
• Consistency not only within a facility but across the entire virtual network of providers within the ACO.

If you think you will be affected by the new ACO law, request a demo to see why PolicyStat’s software-as-a-service offering is uniquely qualified to deliver on this critical foundational element for ACOs.