Comparison of the Transformational Model and
Accountable Care Organizations
Tiresia Kliegl
National University
HCA 402
Healthcare Administration
COMPARISON OF THE TRANSFORMATIONAL MODEL
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Abstract
Healthcare organizations are not only going through technological changes but changes in management practices as well. These changes will challenge healthcare organizations practices, policies, and patient attitude. Comparing the transformational model (TM) with accountable care organizations (ACO’s), this paper will explore how each model improves quality of care, access to care, and reduce cost while discussing their differences. The transformational model focuses on healthcare establishments becoming “learning organizations (Sollecito & Johnson,
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Accountable care organization do not uses the transformational model. Instead, ACO’s are involved with the health outcomes of a certain population (Science Direct, 2014). ACOS treat many Medicare and Medicaid
COMPARISON OF THE TRANSFORMATIONAL MODEL
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recipients. They provide care and are given incentives and bonuses for the number patients they treat. ACO’ us the “fee for services” having the goal of providing care for patients yet avoiding unnecessary services (Science Direct, 2014). ACO’s rely heavily on healthcare providers for leadership where consequences rest solely on one individual. Their values are centered around the organizations goals which typically is concerned with its market value. The quality of care received from ACO’s are typically set in urban areas with large populations. This can lead to longer wait time’s and providers becoming less interpersonal with their patients. With increased patient volume and providers being overwhelmed, the quality of care can be dismal. Overall
ACO’s progress is determined by patient outcomes and improving services for financial incentives. With these financial incentives is one of the challenge that face ACO’s. With
By accommodating to these changes the organization to better serve a greater population at a greater level of quality. Laws and policies also have impacted the organization, such as the Affordable Care Act (ACA). The ACA allowed more patients to have access of healthcare services, driving the demand for health care services higher. This called for the need to increase supplies and staff for the organization. With the ever-changing technology updates, the organization must keep up to date to provide the best quality of care available which can cost an organization extra time and
CMO continues to meet weekly and as needed with division leaders to identify issues and factors that need to be addressed in order to ensure the appropriate operational approaches that should impact clinician as well as client satisfaction and therefore better outcomes. 1. Ongoing in-services for our prescriber staff in the use of our Electronic Health Records (EHR) continue to translate into improvement of the required content in order to justify appropriate billing codings to enhance our collection rates. Chief Medical Officer has personally being reviewing a random number of cases per provider and meeting with them individually to provide feedback and improve their performance. This should also impact obtaining the documentation needed for appropriate coding and improved collections.
The Patient Protection and Affordable Care Act (ACA) approved the use of Accountable Care Organizations (ACOs) to provide protection, value of care and reduce health care costs in Medicare. The ACO program is a charitable program which began on January 1, 2012. An ACO represents a group of providers and suppliers of services such as hospitals, physicians, and those involved in patient care. These individuals have agreed to work together to coordinate care for the patients they serve under the original Medicare. The objective of an ACO is to provide continuous, high quality care for Medicare beneficiaries, simultaneously improve quality and lower costs.
This question represents at least half of the medical community, and makes people question the intended and unintended consequences in a profit - driven health care system, the supposition of quality health today, and whether they
The Accountable Care Organizations are a coordinated effort between healthcare providers to ensure the best quality of care delivered to the patients and at the same time at a reduced cost. This means that health care providers will voluntarily come together to form the ACO and patients will be able to get treated by any provider in the organization. Apart from that, it will reward the providers for delivering quality care. Even though the ACOs is comparatively a new concept, but its certain concepts and features are closely related to early managed care organizations (Barnes et al.,2014). Both MCOs and ACOs rely on the creation of physician network, promotion of member health and resource management to control costs.
Compare and Contrast CIGNA HMO and Heritage California ACO from the lens of the consumer Introduction In the US, there are many health insurance plans designed to meet different individual needs with various advantages and disadvantages of their own. This research paper, focuses on the two different health plan models those are Cigna HMO and Heritage California ACO. Health Maintenance organization (HMO) is basically a type of health plan that limits the freedom of choice of the provider, as the coverage is given to patients who take care from the physicians who contact with the HMO and its main focus is on the prevention and wellness (Wedig, 2013). ACO health plans basically focuses on the care coordination, promote prevention and wellness,
Accountable Care Organizations: The Affordable Care Act (ACA) sanctions the practice of Accountable Care Organizations (ACOs) to bring the advancement in health care space by enhancing the care quality, emphasizing patient’s safety and reduce health care costs in Medicare. This program was begun on January 1, 2012. Its target is not to create any demonstration project, instead it aims to produce an entity which can directly contract with Medicare. The Centers for Medicare and Medicaid Services (CMS) explain ACO as an association of health service providers, i.e. hospitals, physicians, insurers, and others allied with patient care reform that will work together to undertake accountability for the quality of patient care, and how money is spent
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,
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There are many things that define and promotes the use of accreditation as a means of accountability across the continuum of care. The market, regulation, and professionalism all affect the use of accreditation as a means of accountability across the continuum of care. The role of the market play in defining and promoting the use of accreditation as means of accountability across the continuum of care is that money talks. Health care purchasers and consumers can use money as a mean to stimulate organizations to improve quality by either rewarding or punishing the organization base on performance or progress. (1) Healthcare consumers and purchasers are demanding more information regarding quality of care.
These include the creation of accountable care organizations and the implementation of preventative care services, which can reduce the need for expensive emergency care (Rice et al., 2014). Despite these challenges, I believe that the ACA has been a positive step forward in expanding access to healthcare and improving the quality of care for millions of Americans. As a healthcare professional, I support the continued implementation and improvement of the ACA in order to ensure that all Americans have access to affordable, high-quality
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