accountable care organization graphicAccountable care organizations, or ACOs, are groups of physicians, hospitals and other healthcare providers that work together to provide coordinated care for patients. Providers collaborate to give patients the right care at the right time. Following the philosophy of value-based healthcare, patient care is focused on patient outcomes rather than the number of services provided. Physicians and practices that are part of ACOs are given incentives to make care more efficient and effective.

How ACOs Work 

Local healthcare providers voluntarily work together to coordinate patient care. Providers include primary care physicians, specialists, and hospitals. Different ACOs are made up of different combinations of providers. The only thing that must be present in every ACO is a primary care physician because they are vital to making the whole system work.

When a primary care provider’s patient needs a referral to a specialist or hospital, they will refer them to providers in the ACO network. Patients are not usually required to see other doctors in the ACO and can choose to see another provider without it costing more.

The participating providers share patient information with other practices in the ACO, usually through the use of Electronic Health Records (EHRs). When records are shared between providers, they will all have a more complete picture of the patient’s history and their current needs. 

All healthcare providers, including those within an ACO, must comply with federal laws laid out in the Healthcare Information Privacy and Portability Act (HIPAA) to protect patient information. So patients do not need to worry about the privacy and security of their medical information. Patients can also decline to have their records shared with other members of the ACO.

Benefits of ACOs for Patients

Ultimately the biggest benefit to patients is better overall health. Coordinated care improves patient outcomes because there is more incentive to prioritize the quality of care over quantity. With ACOs and value-based healthcare systems, there is a focus on treatment and management practices that prevent future health issues. Not only is a patient’s quality of life improved, but they will have fewer healthcare costs in the future.

Patients who receive care from practices in accountable care organizations benefit from the members sharing medical information. This enables collaborative care that takes a patient’s health as a whole into account. When a healthcare provider has a complete EHR to reference, the number of duplicate tests and procedures is reduced. This allows healthcare providers to focus on the care the patient needs with fewer visits. Not only is the care more comprehensive, but it is more convenient.

Seeing a provider in an ACO can cut down on visits, but increase patients’ access to care when they need it. Many ACOs are able to offer e-services and telemedicine that the individual providers might not be able to offer on their own. Telehealth is an efficient way for simple questions and concerns to be addressed. It can also be used to remotely monitor a patient’s condition.

ACOs can also benefit patients financially. Coordinated care is cost-effective because time is spent on providing needed care during visits rather than re-hashing medical histories and doing repetitive exams, tests, or procedures. That means each appointment has more value while reducing the need for additional visits, which saves time and money.

At South Shore Orthopedics, we are committed to helping our patients get the best possible outcomes from their healthcare. We want patients to get the treatment they need when they need it. Call our office at (781) 337-5555 to make an appointment to experience the benefits of value-based care and accountable care organizations.