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Accountable Care Organizations: Access and Providers

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Does a patient's choice of provider and access to care will be limited under Accountable Care Organizations (ACO)?With an ACO, you'll likely have fewer repeated medical tests because your doctors and hospitals will share information and coordinate your care. Is this a reality or not? In what ways can an ACO succeed in both delivering high-quality care and spending health care dollars more wisely?

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Solution Summary

This response discusses the new Affordable Care Act, health insurance providers and CMS are working towards a model to care for Medicare patients that will yield lower cost, higher quality of care, and a reduction in repeat hospitalizations. Is this a reality or just hopeful thinking?

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Do a patient's choice of provider and access to care will be limited under Accountable Care Organizations (ACO)?

Given that participating in an ACO is strictly voluntary, choice of providers and access to care will be limited. According to CMS, there are several guidelines and restrictions that apply to being in the ACO which may prevent some physicians from signing on. The key to ACOs is care givers working collaboratively and collectively towards accountability for quality and cost of care. Kaiser Permanente, an HMO, has a working model that could easily fit the ACO in with success.
Source: http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ACO/Downloads/Appendix-ACO-Table.pdf

With an ACO, you'll likely have fewer repeated medical tests because your doctors and hospitals will share information and coordinate your care. Is this a reality or not?

In theory it can be a reality. However, CMS has ...

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