The 2010 Patient Protection and Affordable Care Act, often referred to as Obamacare, pushed for Accountable Care Organizations to form in 2012 and provide quality value-based affordable health care as an alternative to today’s fee-for-service system. Analysis by the Oliver Wyman consulting firm suggests that more than half of Americans now have access to an ACO.
The idea behind ACOs is that they will drive down health care costs by pushing high quality and less expensive treatment. This stands in contrast to today’s payment structure that often leads doctors to recommend costly procedures that are not always necessary nor necessarily better. Insurance companies then pay for more expensive procedures at a more frequent rate. ACOs are expected to only recommend treatment that is necessary. Providers in an ACO are rewarded if they keep their patients out of more expensive hospitals.
Forbes reports that ACOs began to provide medical care services to seniors through contracts with the Medicare health insurance program for the elderly last year. Private health insurance companies such as Aetna, Cigna, Humana, UnitedHealth Group, and Blue Cross plan to link with ACOs to extend care to more patients.
Around 40 million Americans are in organizations with ACO arrangements. This is an increase from around 30 million last fall. A report by Oliver Wyman shows that ACOs are most numerous in the Southwest, the Midwest, the Northeast, and Florida. Access is lowest in a path of states stretching across the country from Washington, Oregon, and Idaho down to Louisiana, Alabama, and Mississippi. Fifty-two percent of the population now lives in areas served by ACOs, up from 45 percent in August.
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