Explain Accountable Care Organizations and changes in payment mechanisms including Medicaid
Solutions
Expert Solution
Accountable care organisations are group of hospitals, group of doctors and other health care personnel / providers, who come together voluntarily to give coordinated high quality care to the Medicare patients.
Medicaid :
- States have a great deal of discretion is to set payment Medicaid rates for hospitals and other providers.
- Medicaid payments have historically been below costs, resulting in payment shortfall
- The affordable care act is leading to changes in hospital prayer mix, especially in states adopting the medical expansion.
- ACA calls for reduction in DSH payments, and other federal policy changes are focused on. Limiting the use of supplemental payments
- The goal is to ensure the patients get the right care at right time, while avoiding unnecessary duplication of services and preventing medical errors
- When an ACO succeeds both in delivering high quality care and spending health care dollars more wisely, the ACO will share in the savings. It achieves For Medicare programme
Changes in payment mechanism
- The ability to use electronic networks to store and handle funds instead of having to rely on physical transfer has dramatically changed the financial system. As a result, The transfer of funds has become much faster and safer.
- The transfer and safekeeping of securities has become significantly cheaper since the advent of book entry system.
- The traditional safekeeping of paper based securities in vaults has widely been replaced by such Electronic book entry.
- A new "quantum leap" was made possible by the exponential increase in computer power.
- Because a lower amount of reserves was transferred, the transactions involved both lower cost and higher degree of safety.
- Few Central Bank reserves were needed in a netting system and this was again cheaper for the participating banks.