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presentation

Is Accountable Care Organization (ACO) Model Viable?

January 19, 2012



“Given the situation, although Accountable Care Organization (ACO) model of medical care seems a safer option, yet the initial clinical & operational realignments and adhering to CMS compliance measures may seem a bit exhausting for physicians. But, sooner or later, ACO can become mandatory requiring radical realignments amongst practitioners. Therefore, rather being forced into an emergency, it is better to sail through the evolutionary period, which makes the transition a little bit easier.”

Accountable Care Organization model of medical care – one of the important policy decisions to have emerged from the recent healthcare reforms by the Federal Government – no doubt, promises to be a harbinger of enhanced and streamlined medical care to an ever swelling population of Medicare beneficiaries. But, because of its far reaching influence, the physician community seems rather apprehensive of its incentive sharing model of revenue disbursement among themselves in an ACO model of operation. As Medicare accounts for nearly half of physicians’ revenues, they cannot be indifferent either. As policy decision, ACO model is a strategic way of curbing the Sustainable Growth Rate imbalance (SGR), which has reached its worst possible scenario – an imminent backlash of 25% reduction in Medicare benefits to the physicians associated with treating Medicare beneficiaries.

Given the situation, although ACO model of medical care seems a safer option, yet the initial clinical & operational realignments and adhering to CMS compliance measures may seem a bit exhausting for physicians. But, sooner or later, ACO can become mandatory requiring radical realignments amongst practitioners. Therefore, rather being forced into an emergency, it is better to sail through the evolutionary period, which makes the transition a little bit easier.

  •   Foremost, physicians will to form cartels of heterogeneous medical services, requiring a seamless integration of discipline-specific capabilities for the common cause of quality medical care. Though it might seem easy, yet forging alliances, prioritizing services, and profit-sharing agreement are all going to consume time and resources.
  •   Second, there could be infrastructure make-over necessitated by the mandatory requirement of ACO Model, meaning considerable investment on technology and processes by each of the participating practitioners.
  •   Finally, there is going to be seamless integration of allocated services among themselves, requiring communication and collaborative approach. And, when you add the exhaustive Medical Billing Revenue Cycle Management of realizing reimbursements as early as possible, the overall task of embracing and operating under ACO concept could seem gigantic.

In the face such radical transition, migration to ACO concept initially might seem a rather expensive and exhaustive proposition. But, like its radical nature, ACO concept too holds greater significance in the long-term revenue prospects as the initial efforts will start to yield returns after a considerable gestation period. Therefore, it is rather pre-mature to judge ACO as not viable at all as it has the potential to optimize medical care quality, and expenditure while also being supportive of streamlined revenue generation for physician community.

Having convinced of its long-term potentials, physicians can look implement ACO concept with consultative services from competent medical billing companies. Medicalbillersandcoders.com (www.medicalbillersandcoders.com) – having an indispensable catalyst in augmenting clinical and operational management of diverse medical practices – can be of crucial help. Its self-sufficiency in technical and human resources along with an insider-knowledge of the Healthcare Industry can make your choice of migrating to the ACO concept justified and fruitful.

 

Category : Practice Administration