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Accountable Care Organizations Series
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When analyzing this new aspect of healthcare, there is a proverb to keep in mind,
“I KEEP six honest serving-men
(They taught me all I knew);
Their names are What and Why and When
And How and Where and Who.”1
Under the Patient Protection and Accountable Care Act, Accountable Care Organizations (ACOs) were touted as the new redeemer of the American healthcare industry, promising to lower costs and increase quality for patients and providers. Within the context of these challenging expectations, significant questions have arisen among key industry stakeholders. Health Capital Topics’ new series will explore questions surrounding ACOs within the framework of Kipling’s proverb, i.e. why, what, who, where, when, and how.
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 Accountable Care Organizations Series Part V of VI: When Are ACOs?
Although the concept of accountability in healthcare delivery has existed since the 1930’s, the ACA signaled the widespread introduction of the Accountable Care Organization, As this concept matured, the potential structure of ACOs evolved into several variations including: historical ACOs; Federal ACOs and various incentive programs; and, commercial ACOs. In the fifth part of the Accountable Care Organizations Series, this article considers the question: When Are ACOs?
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Auditing Series: RAC Attack
After the Medicare Recovery Audit Contractor (RAC) program was permanently established in all 50 states as of January 1, 2010, providers failed to experience the anticipated increase in RAC attention. This article examines provider anticipations and reactions to trends in RAC audits, as part one of the HC Topics “Audit Series.”
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Final Rule Could Compromise Value-Based Purchasing Program, AHA Claims
Established under the Patient Protection and Affordable Care Act, the Hospital Value-Based Purchasing (VBP) Program rewards hospitals with financial incentives related to high quality outcomes for Medicare inpatient acute care patients. CMS’s final rule for the VBP program, published May 6, 2011, creates questions regarding the timeline of accountability for hospitals, leading to concerns within the medical community.
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Changes in Survival Rates and US Healthcare
The US continues to have lower life-expectancy rates than other countries, despite outpacing other industrialized nations in healthcare expenditures. Factors such as smoking and obesity have been cited as contributing to the lagging rates. However, a recent study conducted by Columbia University indicates that the U.S. healthcare system itself may be the most significant cause.
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1 “The Elephant’s Child” By Rudyard Kipling, Just So Stories, New York, NY: Garden City, 1912.
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