The Health Care Delivery And Payment Systems Essay

743 Words Oct 25th, 2014 3 Pages
Rising health care costs, a desire for increase access, and improvement in quality care, has the United States shifting focus to reform the health care delivery and payment systems. First there was pay for performance, then with the implementation of Affordable care act in 2010 began the payment reforms with concentration on care that was both quality based and cost effective. Emphasis was on decreasing thirty day readmissions for core measure diagnosis (Congestive Heart Failure, MI, and Pneumonia) and hospital acquired infections. Another measure was the implementation of the Medicare Saving Program and Accountable care organizations. Accountable Care Organizations (ACOs) are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care. ACOs can take on many forms, including hospital/physician joint ventures, physician-owner ACOs, health plan/provider ACOs. These ACO’s work together on the care of patient and share a joint payment, which fosters accountability with all providers. At the heart of each ACO is the patient’s primary care physician, who acts as gatekeeper to control resources, and referrals, still the main measure to control waste. An estimated 14 % of the U.S. population are now being served by an ACO. When Massachusetts was developing its health care plan it supported the formation of Accountable Care Organizations as a cost saving measure. One such example is Atrius health…

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