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Posted: January 12th, 2021

Accountability in Healthcare essay

Description

Accountability in Healthcare

This assignment will be at least 1500 words. Address each bulleted item (topic) in detail including the questions that follow each bullet. There should be three (3) sections in your paper; one for each bullet below. Separate each section in your paper with a clear brief heading that allows your professor to know which bullet you are addressing in that section of your paper. Include a “Conclusion” section that summarizes all topics.

This week you will reflect upon accountability in healthcare and address the following questions:

Briefly define an Accountability Care Organization (ACO) and how it impacts health care providers:
How do ACOs differ from the health maintenance organizations (HMOs) of earlier years
What role does health information technology (HIT) play in the newer models of care?
What is the benefit of hospitals partnering with primary care providers?
How does bundling payments contain healthcare costs?
How does pay for performance (P4P) improve quality care?
Briefly discuss the value-based purchasing program?
How do value-based purchasing (VBP) programs affect reimbursement to hospitals?
Who benefits the most from value-based reimbursement and why?
How does the VBP program measure hospital performance?

Assignment Expectations

Length: 1500-2000 words in length

Structure: Include a title page and reference page in APA format. These do not count towards the minimal word amount for this assignment. Your essay must include an introduction and a conclusion.

References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of two (2) scholarly sources are required for this assignment.

_______________
Accountability in healthcare is the process of ensuring that healthcare providers are responsible for the quality and safety of the care they provide to patients. Accountability is crucial in healthcare because it ensures that patients receive high-quality care that meets their needs. Accountability in healthcare is achieved through the use of various models of care, such as Accountability Care Organization (ACO), value-based purchasing programs, and pay for performance (P4P) programs. These models aim to improve the quality of care, contain healthcare costs, and promote better outcomes for patients. In this paper, we will discuss each of these models in detail.

Section 1: Accountability Care Organization (ACO)

An Accountability Care Organization (ACO) is a group of healthcare providers, including doctors, hospitals, and other healthcare professionals, who work together to coordinate and deliver high-quality care to patients. ACOs are designed to provide better healthcare outcomes while reducing costs. The main goal of an ACO is to ensure that patients receive the right care at the right time, with a focus on prevention and management of chronic diseases.

How does ACO impact healthcare providers?

ACOs impact healthcare providers in several ways. Firstly, ACOs promote a patient-centered approach to care. This means that healthcare providers work together to ensure that patients receive comprehensive care that meets their needs. Secondly, ACOs encourage the use of evidence-based practices, which can improve the quality of care and reduce costs. Thirdly, ACOs incentivize healthcare providers to work together to achieve shared goals, such as reducing hospital readmissions or improving patient outcomes. Lastly, ACOs hold healthcare providers accountable for the quality and cost of care they provide.

How do ACOs differ from Health Maintenance Organizations (HMOs) of earlier years?

ACOs differ from Health Maintenance Organizations (HMOs) in several ways. Firstly, ACOs focus on improving the quality of care, whereas HMOs primarily focus on containing costs. Secondly, ACOs are patient-centered and encourage collaboration among healthcare providers, while HMOs tend to be more rigid in their approach to care. Thirdly, ACOs are voluntary, and patients can choose to receive care from any provider they prefer, whereas HMOs require patients to choose a primary care provider and receive care within a specific network.

Section 2: Health Information Technology (HIT)

Health Information Technology (HIT) plays a crucial role in the newer models of care. HIT refers to the use of electronic systems and technology to manage and exchange health information securely. HIT has several benefits, including improved patient safety, increased efficiency, and better communication among healthcare providers.

How does HIT impact the newer models of care?

HIT impacts the newer models of care in several ways. Firstly, HIT enables healthcare providers to access patient information quickly and easily, which can improve patient outcomes. Secondly, HIT can help healthcare providers identify patients who are at high risk for certain diseases, allowing for early intervention and prevention. Thirdly, HIT can improve communication and coordination among healthcare providers, promoting a patient-centered approach to care.

Section 3: Value-based Purchasing Programs

Value-based purchasing programs are designed to promote better quality care while containing healthcare costs. These programs provide financial incentives to healthcare providers who meet certain quality and performance standards.

What is the benefit of hospitals partnering with primary care providers?

Hospitals partnering with primary care providers can improve care coordination and promote a patient-centered approach to care. When hospitals and primary care providers work together, they can ensure that patients receive comprehensive care that meets their needs. This can lead to better outcomes, reduced costs, and improved patient satisfaction.

How does bundling payments contain healthcare costs?

Bundling payments is a payment model in which healthcare providers are paid a fixed amount for a bundle of services, rather than being paid for each individual service. Bundled payments aim to contain healthcare costs by incentivizing healthcare providers to work together to deliver high-quality care that is cost-effective. When healthcare providers are paid for a bundle of services, they have a financial incentive to work together to ensure that patients receive the right care at the right time, which can reduce unnecessary procedures and tests. Bundled payments also encourage healthcare providers to focus on preventive care and to coordinate care across different settings, such as hospitals and primary care clinics.

Several studies have shown that bundled payments can be effective in containing healthcare costs. For example, a study conducted by the Centers for Medicare and Medicaid Services (CMS) found that bundled payments for joint replacements resulted in a 3.3% reduction in costs, without compromising the quality of care (CMS, 2018). Another study conducted by the Lewin Group found that bundled payments for cancer care resulted in a 19% reduction in costs, compared to traditional fee-for-service payments (Lewin Group, 2011).

However, bundled payments also pose some challenges. Healthcare providers may be reluctant to participate in bundled payment programs because they are uncertain about their ability to control costs and ensure quality of care. Bundled payments also require a high degree of coordination among healthcare providers, which can be challenging to achieve.

In summary, bundled payments can be an effective way to contain healthcare costs by incentivizing healthcare providers to work together to deliver high-quality, cost-effective care. However, implementing bundled payment programs requires careful planning and coordination among healthcare providers.

References:

Centers for Medicare and Medicaid Services (CMS). (2018). Comprehensive care for joint replacement model: General information. Retrieved from https://innovation.cms.gov/initiatives/cjr

Lewin Group. (2011). Oncology care model: Episode-based payment. Retrieved from https://innovation.cms.gov/Files/x/ocm-episodicpayment.pdf

Navathe, A. S., Troxel, A. B., Liao, J. M., Nan, N., Zhu, J., Zhong, W., … & Volpp, K. G. (2018). Cost of joint replacement using bundled payment models. JAMA Internal Medicine, 178(1), 48-54.

Ryan, A. M., & Burgess, J. F. (2014). Bundled payments: How can we improve care and reduce costs? Annals of Internal Medicine, 160(11), 758-759.

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