State Health Providers Navigate Coordination Difficulties To Form ACOs
Health care providers in California are working to overcome coordination difficulties to form accountable care organizations under the Affordable Care Act, HealthyCal reports.
ACOs aim to improve patient care and reduce health care costs.
Golden Life Healthcare is the only ACO in California to receive an advanced federal payment of $1.9 million to establish its infrastructure. The ACOÂ includes 55 to 70 primary care physicians and serves about 8,000 Medicare beneficiaries.
Venu Kondle -- president and CEO of Golden Life -- said efforts to coordinate care as a strategy to reduce and prevent hospital admissions are the mark of socially conscious physicians. He said, "The social responsibility comes from an idea of taking responsibility for what's happening around you, and what's happening around you is that the cost of the care is escalating in a non-sustainable way."
Brown & Toland Physicians in San Francisco is the only ACO in Northern California that participates in the ACO Pioneer Program. The program was developed to address concerns that hospitals might take on too much risk by integrating with physician practices under ACOs, which could cause them to go bankrupt.
Brown & Toland is an integrated practice that includes 1,500 physicians, about 200 of whom serve about 18,000 MedicareÂ beneficiaries as part of the ACO Pioneer Program.
Keith Pugliese -- vice president of accountable care and public policy at Brown & Toland -- said that any organization considering becoming an ACO should consider risk management the key to its success.
Recommendations From Integrated Healthcare Association
James Robinson -- a UC-Berkeley professor -- and other researchers for the Integrated Healthcare Association studied the past 30 years of managed care in California and offered policy recommendations for ACOs in the state.
The researchers found that there is not one ACO structure that is guaranteed to work. They also said that organizations must be committed to coordinating care for an ACO to succeed.
Besides coordination between hospitals and physicians, a key challenge to maintaining an ACO is working with health insurers, according to the researchers.They also found that ACOs can be especially effective in low-income areas of the state (Shanafelt, HealthyCal, 2/13). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.