Making Sense of ACOs: A Guide for Nurse Leaders

Abstract

The upward spiraling cost and declining quality of health care in America contributed to the political environment that supported the passage of the Patient Protection and Affordable Care Act (ACA) in 2010. 1 Anderson G Davis K Guterman S Medicare Payment Reform: Aligning Incentives for Better Care. The Commonwealth Fund, June 2015http://www.commonwealthfund.org/publications/issue-briefs/2015/jun/medicare-payment-reform-aligning-incentives Google Scholar Although imperfect, the ACA challenged our health care system to provide safe, high-quality, and person-centered care. Historically, the care delivery model in the United States has been fragmented, with limited coordination between providers of care, leading to concerns with cost, quality, and access. 2 Barnes A Unruh L Chukmaitov A van Ginneken E Accountable care organizations in the USA: types, developments, and challenges. Health Policy. 2014; 118: 1-7 Abstract Full Text Full Text PDF PubMed Scopus (62) Google Scholar Consensus among many providers, payers, patients, purchasers, and other stakeholders in the health care system is that efforts to deliver person-centered care have been stymied, in large part, by a payment system that is oriented largely toward volume, as opposed to value for patients and caregivers. 3 Alternative Payment Model Framework & Progress Tracking Work Group Alternative Payment Model (APM) Framework: Final Whitepaper. Health Care Payment Learning & Action Network, Bethesda, MD2016 Google Scholar The upward spiraling cost and declining quality of health care in America contributed to the political environment that supported the passage of the Patient Protection and Affordable Care Act (ACA) in 2010. 1 Anderson G Davis K Guterman S Medicare Payment Reform: Aligning Incentives for Better Care. The Commonwealth Fund, June 2015http://www.commonwealthfund.org/publications/issue-briefs/2015/jun/medicare-payment-reform-aligning-incentives Google Scholar Although imperfect, the ACA challenged our health care system to provide safe, high-quality, and person-centered care. Historically, the care delivery model in the United States has been fragmented, with limited coordination between providers of care, leading to concerns with cost, quality, and access. 2 Barnes A Unruh L Chukmaitov A van Ginneken E Accountable care organizations in the USA: types, developments, and challenges. Health Policy. 2014; 118: 1-7 Abstract Full Text Full Text PDF PubMed Scopus (62) Google Scholar Consensus among many providers, payers, patients, purchasers, and other stakeholders in the health care system is that efforts to deliver person-centered care have been stymied, in large part, by a payment system that is oriented largely toward volume, as opposed to value for patients and caregivers. 3 Alternative Payment Model Framework & Progress Tracking Work Group Alternative Payment Model (APM) Framework: Final Whitepaper. Health Care Payment Learning & Action Network, Bethesda, MD2016 Google Scholar