ACO and health care practices
There was a question on what ACO meant for health care practices and as part of reform of current practices. Rusty sends two links he thinks might help:
A guide to Accountable Care Organizations… from Health Reform Watch offers a glimpse:
Specifically, their findings illustrate that there exists wide variations in the cost of care across the country, and profoundly, that the regions that spend more per patient do not necessarily obtain better outcomes. So what to do? Dr. Fisher believes he has found at least part of the answer: the Accountable Care Organization, known as an “ACO”.
And this one here:
Thinking of selling your practice and switching to a hospital-employment model? If so, you’re not alone. In fact, if you aren’t already working as a hospital employee, you’re in the minority: Hospital employment among doctors has jumped from 25 percent in 2002 to 50 percent in 2008, according to the MGMA, and is probably even higher today.
Actually the ACO model is partly an attempt to bring back the old HMO concept. Partly we need to sell the public that seeing a specialist is not a right, in fact the specialist model should move back to a consult only model, with all prescriptions being done by the primary care provider, with advice from the specialist as needed. (The primary care provider could see all medical care and find out conflicts- basically the medical home model).
However somehow people have been led to believe they have a right to see a specialist on the public (or insurance company) dime.
A couple of examples that an ACO might do. 1 Home blood pressure monitors are now less than $50 and are networkable. They might then eliminate the need to visit a provider to check blood pressure. 2 In testing for high blood sugar pre-diabetes, perhaps use the same devices that are used (blood sugar monitors) for a lot lower cost than a hospital test. Again these devices are networkable.
The hospitalist concept ultimatly means that the primary care provider does not need 8+ years of post BS education, and instead of a hospital residency, an assistant position to a primary care physician makes a lot more sense.