Does “ACO” mean anything to you yet? Well if you want to do more than nod and smile the next time you’re around a lot of doctors, read the next couple of paragraphs.
Hospitals that plan to stay in business in Massachusetts are either creating or joining Accountable Care Organizations (ACOs). Today we have a new one of these large “all care under one umbrella” groups: The Beth Israel Deaconess Care Organization (BIDCO) includes the hospital, its physicians’ group and two affiliated hospitals. BIDCO is in talks with Cambridge Health Alliance, Signature Healthcare in Brockton and a few other organizations about joining.
Dr. Kevin Tabb, who runs the hospital (Beth Israel Deaconess Medical Center), says ACOs offer a new and better way to deliver and pay for care.
“For a very long time,” says Tabb, “we’ve taken care of sick patients, doing a good job while they’re here and not thinking about them a lot after they leave the hospital. That felt like a broken model.”
Now, says Tabb, “we’ll think about patients not only when they’re here at the hospital, but after they leave,” and when they are well. Why haven’t doctors and hospitals done this in the past? Tabb offers two reasons: Doctors and hospitals haven’t had the structure to do this and they weren’t paid for keeping people well. Thus the new world, built around the structure of an ACO and financed by a global payment.
If you’ve been seeing a doctor affiliated with Beth Israel, you might be wondering, how does this affect me? Dr. Stuart Rosenberg, who will co-chair BIDCO representing physicians, says “for the first time, we are able to really look at the patient and assess their health care needs no matter where that might be provided.” A doctor will no longer have to see a patient in her office to get paid for delivering care.
Under an ACO and a budget that lets doctors decide how to spend money on patients’ care, doctors are “developing care plans that are limited only by our imagination and the law,” says Rosenberg.
He illustrates with the example of Mrs. Jones, a patient with a chronic disease who isn’t taking her medication, is skipping doctor’s appointments and comes to the emergency room when her blood pressure or diabetes get out of control. BIDCO could send a nurse to visit Mrs. Jones, give her rides to appointments and follow-up with phone calls. And the amazing thing, says Rosenberg, is that we can “provide that personalized care and actually save money on top of it.”
Sounds pretty good, huh? But if you have private insurance or MassHealth, there may be a catch. Continue reading