insurance

Health care reform you can expect in 2012

Accountable Care Organizations
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Accountable Care Organizations

On Jan.1, the Affordable Care Act started providing a financial incentive for physicians, hospitals and health care providers that voluntarily join together to form Accountable Care Organizations, or ACOs, and coordinate care for patients with original Medicare. Under the law, those that demonstrate improved quality and outcomes in care, lower costs and patient priority will share the savings with the Medicare system.

ACOs are expected to save Medicare $960 million over three years, according to HealthCare.gov.

"This addresses one of the main issues, which is the excess cost that we have compared to other first-world countries," says Dr. Stream.

Today, more than 50 percent of Medicare patients have at least five chronic conditions, which may include diabetes, arthritis, hypertension and kidney disease, according to HealthCare.gov.

Zirkelbach says ACOs can both drive down the costs of working with multiple doctors and improve care.

"We have a readmissions crisis in this country, particularly in Medicare where 30 percent of patients that are discharged from hospitals end up back in the hospital within 30 days," he says. "A lot of that has to do with the fact that there is no incentive to ensure that they're getting the appropriate follow-up care."

ACOs are designed to change that.


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