NDLI: Accountable care organizations: the case for flexible partnerships between health plans and providers.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Goldsmith, Jeff
Spatial Coverage	United States
Description	Country affiliation: United States Author Affiliation: Goldsmith J ( University of Virginia, Charlottesville, USA. tcoyote@msn.com)
Abstract	Under the Affordable Care Act, the new Center for Medicare and Medicaid Innovation will guide a number of experimental programs in health care payment and delivery. Among the most ambitious of the reform models is the accountable care organization (ACO), which will offer providers economic rewards if they can reduce Medicare's cost growth in their communities. However, the dismal history of provider-led attempts to manage costs suggests that this program is unlikely to accomplish its objectives. What's more, if ACOs foster more market concentration among providers, they have the potential to shift costs onto private insurers. This paper proposes a more flexible payment model for providers and private insurers that would divide health care services into three categories: long-term, low-intensity primary care; unscheduled care, including unscheduled emergency services; and major clinical interventions that usually involve hospitalization or organized outpatient care. Each category of care would be paid for differently, with each containing different elements of financial risk for the providers. Health plans would then be encouraged to provide logistical and analytic support to providers in managing health costs in these categories.
File Format	HTM / HTML
ISSN	02782715
Issue Number	1
Volume Number	30
e-ISSN	15445208
Journal	Health Affairs
Language	English
Publisher	Project HOPE
Publisher Date	2011-01-01
Publisher Place	United States
Access Restriction	Subscribed
Subject Keyword	Economics Public-private Sector Partnerships Patient Protection And Affordable Care Act Discipline Health Care United States Humans Patient-centered Care Organizational Innovation Delivery Of Health Care Standards Reimbursement, Incentive Journal Article Cost Savings Organization & Administration Centers For Medicare And Medicaid Services (u.s.) Economics, Hospital Legislation & Jurisprudence Discipline Medicine Trends Insurance, Health Methods
Content Type	Text
Resource Type	Article
Subject	Health Policy

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