PHCM9129 Prevention And Management Of Chronic Disease

1.Compare and contrast the impact and incentives of financial models for prevention and chronic care management--for the first four students to post, look at Accountable care organizations, the next 3 to post, bundled payments, and the next to post, fee-for-service.

 

Discuss the effect of new models of care including relative strengths and weaknesses.

 

2.An Accountable Care Organization, or ACO, is a model of care delivery that helps shift the focus toward a value-based payment system, with high quality patient-centered care at the core. ACOs are made up of a group of healthcare providers, such as “groups of doctors, hospitals, and other healthcare providers” who come together with the goal of “lowering costs, improving population health, improving patient’s experience of care, and improving the work life of health care providers” (Nash et al., 2016, p. 201; AAFP, 2018). ACOs focus on eliminating unnecessary care and procedures, with the goal that more wisely spent health care money will result in increased shared savings- the financial incentive disbursed to members of the ACO upon successfully meeting performance standards and lowering health care costs. A potential barrier to this model would be the significant change seen in day to day operations and payment models. As we continue to operate in a fee-for-service, costly model and have a "provider centered model of care" .I think it would be a significant challenge to make this switch- although not impossible.

 

Does anyone have any student or professional experience with an ACO?

1.

The free for service incentive is undoubtedly one of the best model for prevention and treatment of chronic illnesses. I agree the model utilizes highly efficient technology as mostly it is from humanitarian and non-governmental organizations that invest a lot of funds to improve livelihoods of the targeted people. The free for service incentive encourages a lot of people to get treatment and checkups and therefore improves the overall health of the people as it focuses on even those that are reluctant to get treatment (Zuvekas, & Cohen, 2016). I wouldn’t agree completely that the model encourages treatment as opposed to prevention but I do agree that from the results, it is clear that more people are treated than those who get preventive measures. It is therefore true that the model can’t be recommended when the goal is prevention.

2.

I have not had any experience with an ACO but I have no doubts with what you have shared about it. It is a great post and very objective. Accountable care organizations are not profit motivated organizations. As discussed in your post, ACO’s are good financial incentives models of care for chronic illnesses management. These are the most efficient models as they provide patient centered care and they focus on lowering cost and therefore they prevent unnecessary spending from the individuals (McWilliams, Hatfield, Chernew, Landon, & Schwartz, 2016). The model is also remarkable for improving the quality of life of healthcare workers. The main shortcoming however in this model is that people may lose faith in the organizations due to increased cost subsidization. This may affect the operation of these organizations and they may not meet the intended purpose.

References

McWilliams, J. M., Hatfield, L. A., Chernew, M. E., Landon, B. E., & Schwartz, A. L. (2016). Early performance of accountable care organizations in Medicare. New England Journal of Medicine, 374(24), 2357-2366.

Zuvekas, S. H., & Cohen, J. W. (2016). Fee-for-service, while much maligned, remains the dominant payment method for physician visits. Health Affairs, 35(3), 411-414.