Incentivizing preventive practices is exactly the principle behind Accountable Care Organizations (ACOs) and other initiatives forging a new healthcare delivery landscape in the US. But what exactly is an ACO? CMS defines ACOs as a group of doctors, hospitals, and other health care providers, coming together voluntarily to give coordinated high quality care to Medicare patients. In this healthcare model, incentives are tied to organizations demonstrating their commitment to prevention of disease and offering high quality and efficient services where patients will be put first in the continuum of care.
This new payment model, according to Dr. Elliot Fisher in his article “Shift to Accountable Care Organizations” (The Wall Street Journal, Jul 2013), will encourage physicians to improve coordination of care and reduce cost. ACOs will indeed be responsible for the outcome of the care provided to patients, and receive incentives only when their quality measures demonstrate the value of the services provided and an improved patient outcome.
And although a lot has been said about ACOs and other healthcare changes, the medical technology community is still wondering exactly how these changes will impact everyday laboratory operations. To prepare for this transition, many laboratories are switching to electronic health records systems and or upgrading their LIS capabilities. A robust LIS or E.H.R system will be essential in facilitating better communication and interconnectivity of results between ancillary services, health care providers, and patients.
Another topic that laboratorians are hearing a lot about is on enhanced quality standards, and process improvement. The reason for this is that improved quality of services is one of the benchmarks that will be used to measure ACOs’ efficiency and effectiveness. The laboratory, by reducing redundant testing, enforcing correct test utilization, ensuring availability and quality of results, etc., will contribute towards the collective goal of organizational cost reduction, but most importantly improved patient outcome.
In all of this, there’s a hidden opportunity for the clinical laboratory sector to become more involved and a more active contributor in the delivery of healthcare to patients. This new interconnected healthcare model will certainly highlight how effective laboratory decisions correlate to an improved patient outcome.
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