Accountable Care Organizations: A Case Study

Examining the affordable care act (ACA) the expansion of Medicaid will affect the manage care in a big impact (Stefanacci, 2012). According to Stefanacci (2012)manage care organizations will run into the problem of finding primary care providers(PCP) for the more people that will sign up for Medicaid. The affordable care act will have a positive effect on manage care in the long run. I will help alleviate the use of the emergency department for a primary care physician (PCP). It promotes a more healthy population. Help individuals manage their health better by providing them preventive care and reduce the cost for everyone

Despite higher spending on health care, the U.S. health care system ranked last on patient safety, efficiency and equity according to the Commonwealth Fund survey. Our aim should be reduction of high healthcare costs without decreasing people access to health care or sacrificing quality. A collaborative effort is required to work on above recommendations to solve the problems besetting our health care system.

The Joint commission is a nonprofit organization that evaluates health care organizations by recommending them to provide safety, high quality, and value to the public. The Joint Commission evaluates and credits 20,500 health care organizations by providing standards that can be achievable and reasonable therefore improving the health care organizations. A benefit of the presence of the Joint commission is that the community and patients can feel safe when choosing services or treatment from health care facilities because the Joint Commission survey the facilities by making sure that all procedures and care are done in a low risk environment. Health care organizations who are accredited and certified show the commitment that health care

Physicians and Hospitals go hand in hand when it comes to the medical care of patients, and it is this relationship that allows the patients to receive the care they need and deserve. It is also this relationship that we as health care administrators need to understand. In order to fully understand this relationship we need to define the concept of the integrated physician model. We also need to explain the importance of clinical integration in the strategic planning process, and the dynamics of and controversies surrounding accountable care organizations and alternative approaches to the current health system. I will also explain the advantages and disadvantages for hospitals and physician’s models. All of these things are important for health care administrators to understand about the relationship between a physician and the facility they work at.

There are many stakeholders involved with health care administrations. Those stakeholders can be patients, health care physician, insurance providers, pharmaceutical manufactures, hospital organizations, community clinics and government. Each different stakeholder has their own individual vision of health care administration. This causes conflict due to the nature and differences in vision. which then can cause conflicts among each stakeholder involved. A patient is going to have a different idea of how a health care should be managed. This in contrast to the way a physician may think the administration should be managed. Furthermore, each different stakeholder involved would have their own ideal reasons to why the health care administration

Why is Accountability so important in the health care industry? Even though a situation may be positive or negative, every aspect of health care needs to be credited to something or someone, with accountability, errors can be fixed and then prevented and helps keep costs down. An employee accountability is measured by customer satisfaction, results of performance, and the cost and impacts of the employee over time, and affects an organization’s working culture by their values, integrity and work ethics. A successful organization follows the checks and balance process, maintains a positive working culture, and stays clear from blame.

Another alleged consequence of the Affordable Care Act is the improved quality of care-- a major fallacy. The Act has effectively decreased the quality of health care as a result of its compensatory cuts to medical professionals; decreasing funding will undoubtedly destroy the quality of medical practices. Fox New’s Ali Meyer conducted a survey of medical professionals in which half agreed the Affordable Care Act has a negative impact on the medical profession, including reduced quality of

Panning (2014) offers an overview of how the new legislation and its goals are both effective and flawed. Goals of the ACA include: universality, financing, cost reduction, quality improvement, and prevention and wellness (Panning, 2014). Within the context of the ACA is the expectation that the majority of Americans will be covered by health insurance. Furthermore, there should be a more reasonable distribution of cost amongst Americans, with younger and healthier Americans assuming some of the financial burden for those less healthy. Another goal of the ACA is to stabilize the skyrocketing cost of health care. One way to stabilize cost can be accomplished by reforming the way payment and reimbursement of services occurs—outcomes versus volume. A final goal of the Affordable Care Act is to provide incentives that reward wellness and preventative medicine (Panning,

Managed Care is a health care delivery system organized to manage cost. The legal and business imperatives of managed care pervade our national healthcare system, the regulation of managed care depends on who contributes to the plan and who bears the risk for paying for the insured services. More than 170 million Americans receive health care coverage or benefits through some type of "managed care" setting.1 By 2007 about 20 percent of these services are directly provided by a health maintenance organization (HMO), while the majority are served through other managed arrangements, 60 percent in Preferred Provider Organizations (PPO) and 13 percent in Point of Service (POS) plans. Beginning

According to the article many public health agencies also offer outreach and support services such as transportation, on-site child care, and home visiting that are designed to encourage appropriate use of these services. I feel that this is important to be able to offer transportation assistance and children care for some of the percipients. Health plans and public health agencies also may form alliances to gain market power. Plans potentially can attract new members by procuring services from public health agencies, I feel that alliances such as health care plans and public health are very important. These alliances can help serve people that are more likely to use public health. I fell that the affordable care act has made it possible for lots of people to access health care in this country. I feel that these alliances can help with us provide quality care for who are being serviced at public

Healthcare costs in the United States are constantly rising straining the budgets of families and employers. As a result of the rising healthcare costs, insurance premium rates have been also increased. The premiums rates are increasing more rapidly than income which is part of the reason why Americans aren’t able to have access to affordable health insurance. Although the Affordable Care Act has been passed, there are many people still uninsured. The purpose of the Affordable Care Act was to improve the quality of care, provide more Americans with access to affordable insurance, and minimize healthcare spending in the United States. Health insurance premiums aren’t controlled, they are just supported based on income, but cost sharing and benefits are controlled by the ACA (What is ObamaCare | What is the Affordable Care Act?, n.d.).

treat. ACO’ us the “fee for services” having the goal of providing care for patients yet avoiding

The goal of the Affordable Care Act was to provide health care for all U.S. citizens. The idea was to increase access to health care and improve the quality and efficiency of healthcare delivery. However, there are a lot of questions of whether or not the decision to pass this act, or even the ideals it included were ethical.

Under direct contracting, providers must go beyond their traditional roles as suppliers of care to owners of integrated financing and delivery systems. This transition can be difficult for employers to compile and manage actuarial and legal mandates. A physician group can be presented as a threat to health plans, as it does business by obtaining an insurance license. This is because the subcontractor is a competitor. Providers must become active managed care partners with employers, instead of being reactive adversaries of managed care organizations on a contractual basis.