Accountable Care Organizations

Titelangaben

Distler, Franziska:
Accountable Care Organizations.
In: Schmid, Andreas ; Singh, Simone (Hrsg.): Crossing Borders - Innovation in the U.S. Health Care System. - Bayreuth : P.C.O. , 2017 . - S. 69-84 . - (Schriften zur Gesundheitsökonomie ; 84 )
ISBN 978-3-941678-63-7

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Abstract

In the historically fragmented U.S. health care system, care has been delivered by multiple providers with little or no coordination, raising issues with access, cost, and quality. Under the Affordable Care Act (ACA), the Centers for Medicare and Medicaid Services (CMS) is guiding several experimental programs in health care payment and delivery. A fundamental element of this reform is the development of Accountable Care Organizations (ACOs), which offer providers financial rewards if they can reduce Medicare cost expansions and ensure quality standards. Alternative payment models are not only in the center of current U.S. government efforts, but have also gained international attention. Due to their heightened im-portance, this essay provides a general overview of ACOs based on a theoretical analysis of the existing body of literature. Evaluation of cost reduction and quality improvement of early ACOs show promise but also unintended incentives for providers through the benchmarking methodology. Enacting the Final Medicare Shared Savings Rule in 2016, the government is making continuous efforts to reset providers’ incentives to strengthen their satisfaction and maintain ACO participation.