In the 1970s, each patient was assigned an average of two clinicians; today, its 15 providers per patient. As we move from fee-for service and siloed care to bundled payments which use lump sums to drive integration through shared accountability, we need everybody working on the same team. Providers now share the financial risk with insurers. In this increasingly complex world, service distribution is key so pre-acute, acute and post-acute care all need to be connected.
“The nation’s quality and cost problems are rooted in the dominant fee-for-service payment system, which has created a health care ìproductionî model driven by volume and based on incentives to do more, rather than to do better. At the same time, incentives reward bad outcomes, as “curing” the harm from a medical error or a preventable readmission earns additional payment. One of the most promising strategies for improvement is the creation of accountable care organizations (ACOs), in which providers take responsibility for a defined population, coordinate care across settings, and are held to benchmark levels of quality and cost. Unlike some previous delivery system reforms, ACOs seek to balance cost control with efforts to improve outcomes and enhance peopleís satisfaction.”
Accountable Care Strategies
Premier Research Institute