ACO or Accountable Care Organization is a group of doctors, hospitals, medical centers, and other healthcare providers. This unit works together to care for and look after a patient’s health. Their main goal is to improve the quality of care for patients. Ultimately, these add up to clinician’s MIPS reporting services, ACO reporting, or Quality Payment Program.
They are usually responsible for people under Medicare, which allows those patients access to a more coordinated care type that is cost-effective.
How Does It Work?
The main goal of an ACO is to provide you with the best healthcare services possible by a team of clinicians. It consists of
- Primary care doctors and specialists
- Hospitals, medical centers, and long-term care providers
- Local services
Together they find the best solutions for your health issues and submit efforts for rendered services as MIPS 2021 reporting data or ACO 2021 reporting data.
It is also the reason why this type of care is better for patients with chronic illnesses, as they require consistent or regular checkups.
The provider considers your health conditions, consults with the team, and gives you the available treatment options. It can be in the form of medications, tests, procedures, preventative measures, etc.
A point to remember is that you can question your care at any moment. There should be transparency between you and the team working with you, and ACO reporting services reflect that.
Advantages for Patients
There are a lot of benefits that patients can get from becoming a part of an ACO, such as:
Better Quality of Care
Easily the most important one, ACO coordinated care is better for most patients as it allows their doctors to share information. This way, they know what they get prescribed for their particular health condition. Moreover, this adds points to the ACO 2021 reporting as a payment incentive program.
There is complete transparency between you and your team of clinicians. It is understandable as all of us want to be informed about anything to do with our health.
Your doctors have to tell you everything about your care, including
- Medical procedures they might need to perform
- Your medical history
- Your illness(es) or conditions (those that already exist or the ones that might be a side effect)
- Prescribed medications
You are also free to ask them anything you believe you need to know regarding the treatments you are going through. It empowers patients and allows you to score more via ACO reporting services or a MIPS Qualified Registry.
If you have different doctors for different conditions, there might have been times you had to get the same test done multiple times. Or you were given a medication that the other didn’t think was necessary. It can be troublesome as it increases your overall healthcare costs and makes you spend more money than required.
When you are a part of an ACO, your doctors can contact and communicate with each other. This way, they are updated on all of your medical histories and can work together with you to find the best solution for your health issues.
They know who prescribed what, when, can discuss if there is a better alternative, etc. It prevents you from spending time and money on unnecessary procedures and medications, which is one of the purposes of the ACO 2021 reporting.
There is a higher rate of accountability among ACO-affiliated healthcare providers. That is because you can question them at any step, and they are also supposed to communicate with you about everything.
Another thing is that an ACO is required to show that a team is working for your care. They have to show that you are getting everything you need, even the preventative measures such as screenings or shots. They get assessed upon 23 quality measures, and if they are diligent with your care and remain in touch with you, they get rewarded.
Option of Care Coordinator
If you are unsure about the care provided for you, then you can get a care coordinator. It can be someone like a social worker or a nurse who can help with the procedures you are going through and act as a liaison between you and your healthcare team.
They can also monitor, evaluate the care provided, and even supervise or bring together the specialists you might require.
How to Become a Part of ACO?
There are a few ways you can come under the care of ACO, such as,
Joining Through Your Doctor
If your doctor is a part of an ACO, then you can be assigned to their ACO. Also, the ACO itself should inform you if your doctor is a part of one and explain how it will affect your care.
No Changes Required
You do not need to change your primary doctor or even others that are currently working with you. It is perfectly acceptable for you to continue with your preferences, as you are free to go to any healthcare provider, you choose. Moreover, from physicians’ point of view, their quality payment program shifts to ACO reporting services.
to services to require data without using any services as per the environment.
There are advantages to becoming a part of an ACO, as stated in the benefits above. The main thing is that there is communication between you and your healthcare-providing team.
But what you need to remember is that it is not necessary. You can say no when it comes to sharing your information and even change your team of providers if you think they are not the right fit for you. However, as a physician, what’s important is that you gather information accurately and consult ACO reporting services to handle your administrative load for quality data submission.