Accountable Care Organizations Are Failing

Accountable Care Organization

Are Accountable Care Organizations Failing?

What is an Accountable Care Organization? By definition, an Accountable Care Organization (ACO) is a type of healthcare organization that is characterized by a payment and a care delivery model that seeks to tie physician reimbursement to certain quality metrics and reductions in the total cost of care of a particular patient population. For the study, I did a complete analysis and comparison of 10 of the most well known ACOs and Non-ACOs in the country.  Below, you will find a summary of the overall results. The raw data from my study will be published in upcoming posts.

Accountable Care Organization Study Results

1) Accountable Care Organizations (ACOs) will lose an average of 0.67% of their Medicare reimbursement due to high readmission rates whereas Non-Accountable Care Organizations will only lose an average 0.26% of their Medicare reimbursement.

2) ACOs admit more patients to the hospital.

3)  ACOs have more E.R. visits.

4) Patients spend more days in the hospital under ACOs.

5) ACOs generate less patient revenue.

6) ACOS generate less profit.

Accountable Care Organizations Have Failed

Above is a summary of my study results. The next six posts will contain the raw data collected from the study. Based upon the above results, it is clearly evident that Accountable Care Organizations are failing to do what they are supposed to do. For example, re-admission rates should be low and instead they are higher. Hospital acquired infection rates should be low when instead they are high. Length of stay days should be low when instead they are actually high. Low re-admission rates, low hospital acquired infection rates, and low length of stay days are crucial to the success of this type of organization. It is therefore evident that these types of organizations must significantly improve these areas if they hope to be successful in the future.

 

Photo source: flickr.com

Matthew D.  Taber, M.S. is Chief Operating Officer of Medical Access USA (www.medicalaccessusa.com),  a company which offers full access to medical care to patients and  100  percent reimbursement to primary care physicians through direct primary care models.  Reach him by e-mail at mdtaber at me dot com or by phone at 615-669-8347 to receive a free webinar presentation and evaluation of your medical practice.  

 

 

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