Accountable care organizations (ACOs) refer to groups of doctors, hospitals, and healthcare professionals working together. ACOs aim to provide patients with high-quality, coordinated healthcare and services. Organizations may focus on patients with specific conditions, like chronic kidney disease, or patients within specific geographic areas. ACOs manage service costs and use healthcare billing systems to streamline care provision.
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Accountable Care Organization Benefits for Providers
ACOs are designed to help both patients and healthcare providers. The organizations provide a pay-for-value system instead of the fee-for-service model. With this system, patients pay for the quality of services instead of the quantity of services. This new payment model features bundled payments and value-based purchasing. ACOs are the first step toward transitioning to a true value-based healthcare delivery system. Here are two benefits of ACOs for healthcare providers:
1. Patient Retention
Healthcare providers that join ACOs are more likely to gain and retain patients. Accountable care organizations seek to improve healthcare quality while using modern technologies. Patients expect high quality care, so providers focus on the safety, value, and patient satisfaction of their practices. ACOs lead to streamlined processes and protocols and better infrastructure, electronic health records, and information technology systems that improve the overall patient experience. Accountable care organizations also give patients the ability to choose the best provider for their needs instead of settling for the most convenient provider.
2. Increased Profitability
Accountable care organizations can increase profitability for healthcare providers through coordinated care. Coordinated care improves the communication between practices and results in practice efficiency, quality service, and lower healthcare costs.
ACOs also receive incentives from the Center for Medicare and Medicaid Services (CMS). In 2021, CMS distributed about 2 billion dollars to ACOs through the Medicare Shared Savings Program. The figure was $2.3 billion in 2020 and $1.5 billion in 2019, which indicates steady growth for ACOs. In 2022, the number of ACOs was 483, with 11 million assigned beneficiaries. Healthcare providers who participate in the affordable care program can benefit from the incentives and increase overall profitability. Participation in ACOs does not guarantee Medicare Shared Savings Program benefits, but their performance payments can be significant if your practice is eligible to receive them.
Accountable Care Organization Benefits for Patients
ACOs shift practices to patient-centered care with an emphasis on quality. Practices that meet ACO benchmarks created by Medicare will likely improve patient care while reducing their overall cost. ACOs only provide the necessary patient tests and procedures because reimbursement is based on quality, not quantity. Within ACOs, health records are verifiable and communicated between practices, so patients are protected from unnecessary treatments. Providers can use the health record coordination system to see previous tests and services performed for a patient to prevent duplication and extra costs.
Other benefits of accountable care organizations for patients include enhanced communication, accessibility, and reduced paperwork. Patients can easily contact their primary care physicians for any medical questions, requests, or treatment information. ACOs also provide two-way communication, allowing patients to become involved in their healthcare decisions. Under ACO, all medical records, including healthcare billing, are readily accessible to all providers. This means patients won’t need to spend time filling out the same paperwork for each provider they visit.
Improved population health is another benefit of ACOs. Properly structured ACOs can improve the health and wellness of patients within a defined population. Some ACOs are formed to care for patients with specific health issues. These ACOs can help improve the health of the population by promoting preventative care. Other ACOs have a broad scope, focusing on improving the quality of primary care services and coordination for patients across all levels of care.
Accountable Care Organizations & Healthcare Billing
ACOs use modern healthcare billing systems and revenue cycle management platforms to streamline their accounting. Billing services can improve clinical, financial, and operational outcomes for medical organizations of all sizes. A reputable billing platform that supports expert revenue cycle management and integrations can improve the function of an entire ACO.
Accountable care organizations in healthcare are revolutionary as they are shifting from the traditional fee-for-service model to a pay-for-value model. ACOs allow patients to have the best possible healthcare experience. Through ACOs, providers can enjoy better coordination, communication, and efficiency within their practice. The goal of accountable care organizations is to increase the quality of patient care and eliminate inefficiencies that interfere with healthcare coordination.