Big changes have been sweeping through the U.S. healthcare industry in recent months, as many of the Patient Protection and Affordable Care Act's provisions go into effect across the country. In addition to highlighting the need for greater health information technology systems – such as electronic health records – to improve the efficiency of medical practices, the ACA has also pushed for the integration of accountable care organizations into the system, according to the Centers for Medicare and Medicaid Services. These groups are made up of doctors from various specialties – from orthopaedics to pediatrics – volunteering their services to provide coordinated patient care, often for individuals with chronic illnesses.
While proponents and opponents of federal healthcare reform legislation have been debating the effectiveness of the ACA and its provisions for several years now, new evidence is beginning to emerge supporting the benefits of ACOs. A recent study examined how ACOs impact the cost-effectiveness and quality of care of common medical procedures, finding that these organizations may actually be more versatile and affordable than smaller hospital and healthcare groups.
ACOs in a changing healthcare environment
According to Reuters Health, a team of expert healthcare investigators from Harvard Medical School in Boston authored a study on the effectiveness of ACOs. The researchers found that in many cases, ACOs provide patients with better quality of care while keeping medical costs lower than smaller medical practices.
To arrive at this conclusion, the Harvard investigators looked at data collected in 2009 on nearly 4.3 million patients enrolled in Medicare. The researchers specifically looked at how many patients hospitals, medium-sized practices, large practices and small medical groups handled to determine the efficiency of their operations.
Based on this information, the study found that, in 2009, hospitals spent about $12,181 on Medicare patients as opposed to $11,332 for smaller healthcare organizations. However, the lowest cost-per-patient was achieved by large and medium ACO groups, which managed to spend $11,275 for every Medicare recipient seen.
"I think our analysis is sort of searching for pockets of excellence and seeing whether those pockets of excellence echo the ACOs. We found they do," J. Michael McWilliams, M.D., from the Harvard Medical School told Reuters. "No matter the type of organization, primary care orientation was associated with better quality and lower spending relative to smaller practices. Ten years down the road, the ideal would be for ACOs to be far more sophisticated and better at providing care than any organization that's already out there."
ACOs taking a risk on health IT
The Harvard study also found that ACOs tended to be most cost efficient when they took risks on implementing new strategies and procedures, even if there appeared to be no immediate financial advantage to doing so. Health Affairs blog echoed this support of risk-taking ACOs, especially when it comes to implementing health IT, like EHR systems.
As ACOs are paid by Medicare depending on the quality of services provided, incorporating EHRs into daily operations can up overall practice productivity. This is both a benefit for doctors, who are more likely to be rewarded for their services, and patients, who get better quality medical services at an affordable price.
In fact, the Certification Commission for Health Information Technology established the HIT Framework for Accountable Care to help medical professionals understand the necessary steps toward using EHRs. By jumping on board with the latest technology in the healthcare industry, ACOs can continue being positive forces of change in regard to ACA reforms.