In the healthcare industry, management can be quite tricky. Because of how big and multilayered a health organization is, a lot goes into making Healthcare Executive Decisions. One of the ways this is done, is through Accountable Care Organizations. Accountable Care Organization ACOs are outlined as hospitals, clinics, other care facilities and doctors working together using healthcare executive decisions to bring the best care to patients at reasonable costs. Coordinating care to ensure that patients getting the right care at the right time while avoiding waste is the grand goal, and the structure by which it can be framed is the Triple Aim program. This specifies:
- Improvement in patient care, specifically quality and satisfaction
- Improvement of population health
- Reduction to costs of healthcare and healthcare programs
This agenda helps healthcare facilities across the United States to be uniform and also be responsible in the same manner. It likewise allows the HHS to quantify what organizations are doing well and what needs to be improved upon. Many expectations and mandates start within government regulatory programs, and right now healthcare is a huge proving ground for what might be coming down the pike for all healthcare facilities. Some expectations that are being tried and being worked over for implementation across the board include:
- Risk stratification care management
- Increasing access and patient continuity
- Planned care for those with chronic conditions
- Planned care for preventative treatment
- More engagement with patients and caregivers
- Coordination of care with different facilities and providers
To help take on the plethora of features that go along with such a large operation, a Healthcare Transformation Task Force is forming a coalition from healthcare payers and providers. When dramatic changes come down, a clear path of communication needs to be established, one where questions can be answered and where responsibilities can be assessed. It also is extremely helpful for all involved if it is one entity instead of many groups or units. The more streamlined means a more concise way of handling the bumps in the road ahead.
The overall premise behind the change and the task force comes down to basic ideas of improving the quality of healthcare and bringing costs down. These are simply stated goals but far from simple to achieve. The many facets that would go into them are far ranging and unique to each organization.
No system or setup is perfect, and change is always going to rock the boat. When you’re playing in the realm of healthcare and trying to better the structure as a whole, some sacrifices and risks must be played out to see what happens. ACOs are on the frontline of making some of this come to fruition and be the testing grounds to provide some risk assessment. Taking care of healthcare is an investment in the future for each of us.
Removing ‘Fee-for-service’ Mentality
Doctors knew years ago, that if they prescribed more test and procedures, they would get paid more. This didn’t always sit well with patients, who were sometimes subjected to unnecessary and expensive practices, some of which were invasive. Most physicians didn’t abuse this license to direct care of patients, but unfortunately, there are always a few that spoil it for the rest. As a result, part of the directive with being recognized as an ACO was moving away from a patient or insurance company paying for each procedure, to a pay for performance, which regulates and watches organizations to see if patients are being readmitted to hospitals too often, if patients continue to be seen for the same issues and if duplicate testing and events are being asked of the patient.
This moves the responsibility to ensure that patients are receiving the best care possible on to the shoulders of the physicians and healthcare organizations, instead of just demanding a patient be subjected to pointless actions. The assumption in risk is offset somewhat by managing the care of patients more closely, and working with the patient to bring about positive results. A close relationship with a patient, with the added assistance of a digital health record, allows for more precise care rather than the buck-shot method, where if you throw enough tests at a person, you might hit the target.
Healthcare Executive Decisions and Coordinated Care
Moving away from the older way of doing services in healthcare where one doctor’s office didn’t really share information unless directed with another office is necessary. Part of what is making this easier is the move from hard copy medical documents to digital. This allows one office or organization to quickly pass along information to another without much effort and without the worry that a patient being burdened with long wait times.
This is especially helpful with an aging population, which on average has 15 different physicians and sees a doctor over 40 times per year. To avoid duplicate tests and unnecessary repetition in procedures, it is vital that different offices and organizations talk to each other. This kind of coordination also helps to alleviate confusion or conflicting information that a patient might otherwise receive. This kind of continuity also goes to providing better care at a lower cost for all those involved.