What is an ACO?


It seems like every so often there is a report on the news or Internet that talks about the condition of the healthcare system and all the problems that lie within.  The government is always getting involve in order to make it better, and by doing so the government makes new regulations and requirements to be followed.  And, it isn’t that the healthcare industry isn’t working to make sure patients receive great care, but sometimes it could be said that the hand doesn’t know what the foot is doing, thus nothing is working well together.  To help propagate more continuity in healthcare, the concept of Accountable Care Organizations was established, but exactly what is an ACO?


It used to be that acquiring and holding onto knowledge was a way to guarantee job security.  This isolation of data didn’t just carry in habit when talking about people, but also when computer data was compartmentalized.  If one department or section of a company held more data, they were seen as more important and valuable within the system as a whole.  For many businesses and industries, that isn’t too much of an issue, but can create a divide that is difficult to overcome.  Within the healthcare system, isolation of data is one of the last things that you want to have happen.  It may seem a little strange that there should be an openness when it comes to sharing data, especially when wanting to keep some data private depending upon the person accessing the file.


There are a few reasons why segregation of data should not be happening, particularly in an age of digital data.


Coordination of Care


Most of us have a preferred doctor or clinic that we regularly utilize for care.  Most of our medical information is stored and accessed at that location, and there isn’t a necessity to share that information with other offices, hospitals or doctors.  This may not always be the case; take for example if you happen to break your arm.  Many family practitioners aren’t able to take x-rays in their normal office, so you are sent to a hospital or larger set of specialists’ care to get that done.  From there you find out that you have to have surgery to place the bones back correctly.  Maybe there is some physical therapy that is recommended.


As you can see, it doesn’t take much to be involved with different specialists, different offices and a vast amount of information that is needed in order to provide the best, and most efficient care for you. 


To avoid having to carry around your medical file and transport information from one office to another, your medical documentation is now done digitally and can be transmitted and shared across the street or across the country, if necessary.  By doing this, there are less chances that your information will get lost, will eliminate the likelihood of duplication of tests or procedures, will reduce the time needed to schedule appointments, and overall help in the short- and long-term outcomes of your health and healing. 


This can be seen even more directly with people who are very ill, have many doctors and specialists that they are working with and may have added care needed at home.  Coordinating of care not only helps to ensure the best outcome possible, but to reduce the cost of care be reducing waste or repetition that might otherwise occur.


Real-time Help


Many of us have an expectation of instantaneous answers to our questions.  This is also true when it comes to healthcare.  When we are sitting down with our doctor at our yearly physical, we all understand that we are probably not their only patient, they probably don’t remember much of anything about us from a year ago, but expect that they will be able to renew a prescription, advise us on things that we should be doing better, and let us know anything new that we should be adding into our lives.  By having our information right there in the computer, the doctor is able to quick assess what has happened, see if anything new has come up and provide the advice that we are seeking.  This can all be done right there instead of having to return for repeated appointments, and if necessary, when information can’t be provided on the spot, it can be sent to us or accessed through the patient portal.


For a yearly physical, this may not be as critical as it would be if you had been brought into an emergency room to a hospital that you may never have been to. When those medical professionals are able to bring up your information and know that you have an allergy to nuts, they can more appropriately work to handle your situation with that sort of prompt response to directives.  Thus, decreasing the probability of negative treatments or long-term health effects that could have been avoided.


Controlling the Cost of Care


It almost goes without saying that the rising cost of care is out of control.  We all understand that technology has helped to improve the care we receive, and that no service is provided for free, but we also can see that we aren’t necessarily receiving a vast improvement in care when compared to the percentage increase to dollars being paid out. 


Healthcare organizations realize this, too, and are making it a priority to bring this ever-growing increase under control.  To do this, it is essential to find out where the organization is doing things right, and where waste is happening, so as to eliminate it.  This is done by utilizing the data that is being gathered every day.  With the help of healthcare software, which is specifically designed to drill down the healthcare data, patterns begin to emerge that provide insight as to what is happening within the walls of the organization. 


Armed with the information of ongoing patterns, as well as taking into consideration all the regulations and reporting that must be done in healthcare, organizations can find out where changes need to be made, make better and more defined goals, and eliminate wastes that happen with time, energy, resources, and personnel. 


All of these together help to answer the question: what is an ACO?  The hardest aspect in all of this is that the healthcare industry is trying to hit a moving target; no matter what they have gotten right in the past may not be enough for today’s standards, and may not be enough to meet new government mandates.  However, with the right tools and knowledge, that moving target can be a lot easier to hit, and in the process, help to provide better care for patients and keep the cost associated with care under control.



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