Thursday, April 12, 2012

Accountable Care Organizations and Medicare

I remember going to an off-site lab for tests one day.  A male patient there, senior in years, was arguing with the clerk at the window.  It appeared that he had been to the lab weeks ago to have some blood work done as requested by his doctor.  The doctor had never received the results so the patient had come to the lab to obtain them.  The only problem was that the lab did not have the test results.  As a matter of fact, they didn't even have his lab tests.  They had been lost in some black hole  - most likely in the lab itself since they performed all test results right there.  The man was clearly frustrated.  His insurance had never been billed for the tests, either, so it was his word against the lab's that he had actually had the blood drawn.  No wonder his voice was rising a few notches.  Of course, being a senior citizen, I'm sure the young woman at the window put it all down to a "senior moment".

Well, scenes like that hopefully will happen fewer and fewer times starting - soon.  The Centers for Medicaid and Medicare Services (CMS) has announced that 27 Accountable Care Organizations have signed up to work with physicians and hospitals to help coordinate care for Medicare patients so that scenes like the one described above become the exception to the rule.

If we count the Pioneer Accountable Care Organizations and the physicians groups that CMS announced in 2011, the number of such organizations working toward better care coordination and shared savings for patients now numbers 65.  According to CMS, they are reviewing almost 3 times that number of additional applications for entry into the program in July 2012.

Read more about the status of Accountable Care Organizations in Mary Mosquera's April 10, 2012 article entitled "CMS unveils "27 Medicare shared savings ACO's" on  These organizations come courtesy of the Affordable Care Act "Shared Savings Programs" which is expected to lower costs by improving health care.

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