Integration without Employment

Something that is on the minds of most Americas while we vote this week for our next president is the state of nations healthcare system and the options that will be available to us in the days to come. One of the key topics that need to be addressed and is also the focus of this article is, how to address the risk of reduced payment by finding innovative ways to decrease the overall cost of the service but at the same time improving the quality of the service being provided.

This paper revolves around Accountable Care and the authors of this paper present three models for hospital physician alignment strategies which could be applied for Accountable Care:

§  Co-management arrangements

      §  Clinical joint ventures

§  Shared physician leadership structures (Professional services agreements with performance incentives)

Accountable Care proposes that hospitals get away from the traditional approach of having to rely on medical directors and administrative influence for inpatient operations and move towards a more robust system that consists of outsourcing the management of these services to a co-management company thus having access to more expertise and also experience be it doctors or medical staff. Thus ownership will be split between the hospital and the doctors / physicians as per the agreements with the co-management company. The goal is to eventually move the health care system away from a pervasive episodic payment approach and towards a more coordinated and preventive model of care delivery. 

Many critics argue that Accountable Care only gets us half the way and there are many challenges especially with most of the Accountable Care Organizations having to rely deeply on software tools to deliver a more cost effective patient care.  And it can also be noted that a failure to co-ordinate care can often lead to patients not getting the care they need, receiving duplicative care, and being at an increased risk of suffering medical errors.

But an improved co-ordination and communication among the providers, suppliers and doctors can definitely improve the quality of service being provided and also hopefully lower costs. And what remains to be seen in the days to come, is if our Health Care Managers of tomorrow will be able to cope with such a system and get off the vendor mentality back towards a healthcare provider mode thus bringing about changes and reform in the payment and delivery system.

Resources:

Article Source: HFM (Healthcare Financial Management); Aug2012, p54-62, 9p

Article : “Integration without employment”  http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=78388384&site=ehost-live
ISSN: 07350732     Accession Number: 78388384

 

http://www.healthcare.gov/news/factsheets/2011/03/accountablecare03312011a.html

http://en.wikipedia.org/wiki/Accountable_care_organization

http://www.accountablecarefacts.org/