Accountable Care Organizations free essay sample

The Next generation of Healthcare in America| | Accountable Care Organizations and the National Healthcare System The Next Generation of Healthcare in America National healthcare has been a hot button issue around dinner tables in America for years. Everyone seems to have an option on what will or will not work, how our county will afford it and what a plan would entail. Although we are unsure of how a plan would affect the country or the average American. Whether one is for or against the current healthcare plans that have been put in place by our government, We can all agree that the need for a national healthcare system is due to rising healthcare cost, the rapidly rising rate of uninsured American in our county and the rising cost of the average insured healthcare premiums through their employer based healthcare coverage plan. Accountable Care Organizations Could be part of the answer to the healthcare puzzle ACO’s offer a several befits to help to help curb spending and over utilization of healthcare by setting accountability, quality, and Healthcare standards. We will write a custom essay sample on Accountable Care Organizations or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page No one can argue that the United States of America has a grave need for some type of national healthcare system one reason for this is the rapidly rising cost of health care. The rising cost of healthcare is due to several factors. The main causes are technology, prescription drugs, chronic diseases, aging populations, and rising administrative cost. The cost of technology and prescription drugs has sky rocketed over the last several years. Analysts agree that the rising demand for the development of technology driven services and prescription drugs whether they are more effective than previous technologies and drugs or not has a large direct effect on the total healthcare cost. Consumers are demanding availability of these more expensive technologies and drugs as they are developed, even if they are not as cost effective as other services that are available. United States Congress) Accountable Care Organizations Could help reduce some of the overall expenses of the current healthcare model. ACO’s are based on a quality metric system where payment delivery reform is tied to provider reimbursement quality. They do this by looking at the reduction of the total healthcare cost of a given population. ACO’s use a range of different reimbursement models like fee for service and captioned Payments, it is believe that becau se of this fee schedule providers will focus more on quality of care and less on amount of patients cared for. Providers are then held accountable to third party payer for their appropriateness, efficiency, and overall quality provided. Medicare states that an accountable Care Organization is, an organization of health care providers that agrees to be accountable for the quality, cost, and overall care of Medicare beneficiaries who are enrolled in the traditional fee-for-service program who are assigned to it. † (Brookings Institution) Chronic diseases and aging populations are also a large cause for the rising cost of healthcare. The nature of health care in the U. S. has changed dramatically over the past century with longer life spans and a greater presence of chronic illnesses. The new ageing population with chronic diseases has placed a tremendous demand on the health care system, particularly an increased need for treatment of ongoing illnesses and long-term care services such as nursing homes. Analysts have gathered that Aging population and People with chronic diseases makes up over 75% of the total healthcare cost In the United States (Centers for Disease control). Rising administrative cost is also affecting the average American healthcare cost. It is estimated that Medicare spends less than 2% on average of their total budget on administrative cost while the privately insured system spend an estimated 7% of healthcare spending on administrative cost. Some analyst argues that the mixed public-private system creates overhead costs and large profits that are fueling health care spending (history of healthcare). Accountable Care Organizations can help curb over s spending with the use of accountability factors that have been put in place. Because of the span of an ACO, the population it will oversee, and the size of the group of healthcare providers overseeing the patients needs there will be an elimination of duplicated and unnecessary healthcare service. This will also flow into their quality model of patient care where they have put in place checks and balances to make sure that a patient medical needs are being looked after to the highest standard, if providers do these effectively they will receive financial incentives. Secondly the rapid rate of uninsured Americans in the United States largely contributes to the overall cost of healthcare as well as health insurance and every American is affected. In 2004 the total cost of healthcare for the uninsured in the United States was (including both those without coverage for all or part of the year) almost $125 billion and there were 44 million Americans who were uninsured. Of the total healthcare cost accrued in 2004 by uninsured Americans uncompensated or unpaid healthcare is estimated to be $40. billion dollars. The federal government pays for over two-thirds of this by making payments to hospitals in the form of Disproportionate share hospital (DSH) payments—payments intended to offset losses hospitals. These payments are appropriated when hospitals incur large shares of their patients that are unable to pay their hospital bills (Kiser commission). Over all this cost every single American, because we have to pay more taxes and health insurance cost rises to offset the under payment of others. Under the national healthcare bill that has currently been put in place every American will need to be insured. If this bill does go into effect ACO’s will allow the united states a way to Manage large populations and monitor healthcare cost and disease in geographic areas more effectively. (Accountable Care Stories) Lastly the Sky rocketing cost of healthcare premiums is affecting every insured American As well. Most Americans who have insurance are insured through their employer, nearly 160 million. The average cost of a family policy now exceeds $13,000 a year, having doubled over the last decade. Employees are not only paying more than their share of premiums — $3,515 a year, on average they are getting less coverage for the money. Employee’s out-of-pocket contributions are increasing through higher annual deductibles and co-payments. It is also estimated that if this trend continues these increases would translate to the average policy for a family costing around $24,000 a year in the span of one decade. (Kaiser family foundation). Accountable care Organizations should also aid in reducing the overall cost of our healthcare. Because of the standards put in place by ACO’s, there should be a reduction of services that are unnecessary and not beneficial to the patient. The goal of the Organization and its creators is to reduce healthcare cost, by placing the emphasis of care back on quality and not on the amount of people seen or service provided in bulk. By providing quality healthcare services the patients should see reduced insurance premiums. (Shannon Cliff, and Karen Wolk Feinstein PhD. In closing although everyone cannot agree on a national healthcare system to put in place the facts are that the system that we currently have in place is very broken and does not offer all the things that the average American needs within its limits and terms at an affordable cost.