As an independent physician, embracing the autonomy of your practice is who you are. But managing the complexities of healthcare delivery and financial sustainability can be challenging, stressful, and time consuming.
Joining an Accountable Care Organization (ACO) is one way you can support your choice to remain independent while easing some of the burdens.
In case you’re not in the know: an ACO is a network of doctors, hospitals, and other healthcare providers who voluntarily come together to provide coordinated care to their patients.
They share a common goal of improving patient care and reducing healthcare costs by making patients a priority. Giving each and every patient the right care at the right time helps improve outcomes while avoiding an unnecessary duplication of services and preventing medical errors.
There are three main types of ACOs:
Medicare ACOs
These groups focus on improving outcomes for patients on Medicare. They participate in programs like the Medicare Shared Savings Program and REACH programs, which reward ACOs physicians for reducing healthcare costs through efficient care management while maintaining quality standards.
Medicare ACOs not only focus on the benefits they bring to Medicare patients, they also streamline processes to prevent hospital readmissions and ensure follow-up care is timely and effective. By focusing on coordination of care, they help manage chronic diseases more effectively. And studies show that as patient satisfaction goes up, long-term healthcare costs often go down.
Commercial ACOs
This type of ACO is made up of partnerships with private insurers. They vary in terms of structures and agreements depending on the specific aims of the insurance providers and the healthcare entities involved.
Commercial ACOs, while similar to Medicare ACOs in their purpose, often involve more customized arrangements with private insurers. These can include unique performance metrics and incentive structures designed to align more closely with the business objectives of both the healthcare providers and the insurance companies. Having this flexibility allows for innovative care approaches tailored to specific health populations.
Medicaid ACOs
Especially designed to serve Medicaid beneficiaries, this type of ACO concentrates on integrating services for low-income patients with complex healthcare needs, emphasizing the coordination of medical and social services to improve health outcomes.
Medicaid ACOs provide a vital service by focusing on a demographic that is often underserved. These ACOs play an important role because they take a comprehensive approach to healthcare that addresses both physical and mental health needs. Their role in managing care for patients with multiple, complex conditions is instrumental in improving outcomes for some of the most vulnerable populations.
Empire State Health Partners, is a Medicare ACO. We offer our members financial and regulatory support as well as a host of clinical advantages that come with being part of a larger network.
Within our group, independent physicians are able to collaborate on best practices and gather insights from a diverse group of healthcare professionals. This helps every one of us take a more thoughtful and effective approach to patient care.
Joining an ACO makes you part of a community where everyone helps each other navigate the complex healthcare landscape together yet still maintain the core values at the heart of an independent practice. For many docs, it’s a step towards balancing independence with the advantages of collective resources.
If you’d like to learn more about Empire State Health Partners or ACOs in general, I’d love to hear from you. Contact us here.