{"id":751,"date":"2012-02-06T06:00:54","date_gmt":"2012-02-06T06:00:54","guid":{"rendered":"http:\/\/www.medicalbillersandcodersblog.com\/?p=751"},"modified":"2026-05-11T11:21:21","modified_gmt":"2026-05-11T11:21:21","slug":"balancing-aco-objective-with-physician-reimbursement-maximization","status":"publish","type":"post","link":"https:\/\/www.medicalbillersandcoders.com\/blog\/balancing-aco-objective-with-physician-reimbursement-maximization\/","title":{"rendered":"Balancing ACO Objective with Physician Reimbursement Maximization"},"content":{"rendered":"

As the U.S. healthcare sector looks up the Accountable Care Organization (ACO) Concept of healthcare delivery with great expectation, physician community is quite apprehensive about their ability to garner reimbursements under a new healthcare delivery altogether. While ACO itself is not a novel concept \u2013 there have been umpteen examples of institutions operating on ACO lines \u2013 the urgency is such that it warrants an immediate action by the physician community, who can effectively bring down the spiraling healthcare expenditure while promoting quality medical care for an ever growing patient base.<\/p>\n

While the Federal Healthcare Department seeks to bring the unsustainable growth rate in healthcare rates \u2013 estimated to be 17.3% of the gross domestic product and projected to be 19.3% by 2019 \u2013 there needs to be complementary effort that can rein in spiraling U.S. healthcare costs, expand access, promote wellness and improve the consistency of quality outcomes. Although the task needs to be jointly accomplished by the physicians, health insurance carriers, and policy makers, the role of physicians becomes quite pronounced as they hold the key to success or otherwise of the Accountable Care Concept.<\/p>\n

Notwithstanding their apprehension about their ability to garner a steady flow of reimbursements under the ACO Model \u2013 in an ACO, providers will no longer be rewarded for the volume of care provided to those who are sick; instead they will be paid based on their ability to keep people healthy with minimal procedures \u2013 physicians would do well to integrate their operational model for better patient experience.<\/p>\n

Once they can build goodwill based on better patient experience, the volume will take care of itself as satisfied patients themselves become brand ambassadors for promoting physicians\u2019 services amongst newer markets. But, before all this can happen, physicians, willing to be in an ACO Model, need to:<\/p>\n