When I first heard about the Accountable Care Act, I thought to myself, “I have been a physician for over 30 years and I think we’re doing a good job. We’re doing our best to provide the highest level of care.” However, if you look closely at what the Act tries to promote, it’s hard to argue with its goals. The aim of the Act is to improve the health of our population while decreasing the cost of care. Evidence shows that our population, relative to others in the world, is not very healthy and we spend more on healthcare in the U.S. than any other industrialized nation. That said, it’s hard to argue with the objectives of Accountable Care.
What do we mean by accountable care?
What are we accountable for? And to whom are we accountable? Well, we’re accountable to employers, our community…and most importantly our patients.
We are accountable for providing the highest value healthcare to patients that we can—that means the highest level of quality. The best outcomes and service at the lowest costs.
What does it mean for patients?
For patients, care will be provided by healthcare teams, which will include not just physicians, but other healthcare professionals, such as nurse practitioners, physician assistants, social workers, and health educators. These teams will increase the coordination of care across the spectrum. For instance, these teams will ensure patients know about their medications as they leave the hospital, inform patients about what to expect during future appointments and help patients keep their appointments. The healthcare team will focus more on the transitions of care and assisting patients with navigating those transitions seamlessly. This coordination is important because we want to prevent unnecessary care, such as readmission to the hospital or having to go to the ER for a condition that should respond to appropriate treatment at a physician’s office.
What does it mean for physicians?
For physicians, we must place more attention on preventing and better managing chronic diseases. Our population is in an epidemic of chronic diseases—obesity, diabetes, heart failure. Rather than being episodic in our treatment of patients’ ills (which has characterized our system over the last 40 years), we have to invest much more in prevention and systematic coordinated, multidisciplinary management of chronic diseases. With Accountable Care, there will be a great deal more effort put into assisting patients with their health literacy, improving their adherence to recommended regiments of treatment, increasing their understanding of their condition, and changing their behavior.