Receiving quality and timely medical help is necessary for all people, and everyone expects to be treated with care and support. However, not all patients can afford expensive treatment methods or medications. Additionally, it happens that doctors prescribe a vast number of tests or repeated studies or only provide a choice between costly treatments. Not all patients can afford it, and the quality of provided services reduces. That is why modern healthcare providers aim to improve patients’ health and experiences while reducing their costs, and specific programs are created to motivate medical facilities and workers. However, some critics mention that the existing financial incentives are not very effective and do not have enough impact on the quality and value of health care (Doran et al., 2017). The purpose of this paper is to discuss those financial safeguards that exist for patients and also talk about the efficiency of Accountable Care Organizations (ACOs).
To begin with, there are several financial safeguards that can help patients receive the necessary treatment or medications. First, health insurance can cover one’s expenses and allow patients to save money on costly treatment methods or even trips to the emergency room (Adams, 2019). Further, there is also an option of having disability insurance that can pay one’s everyday living expenses in case a person is disabled after an accident (Adams, 2019). Finally, there are Patient Assistance Programs that make it possible for people to purchase costly medications (Patient Assistance Program Center, 2021).
Further, it is essential to talk about Medicare Accountable Care Organizations, also known as ACOs. The idea of establishing ACOs belongs to the Center for Medicare and Medicaid Services, which implements and designs numerous programs to promote more effective coordination of healthcare providers while delivering value-based care to their clients (Centers for Medicare & Medicaid Services, 2021). Doctors’ offices, hospitals, and other providers are encouraged to form ACOs to get incentivized to improve patient health and care quality while also reducing costs.
ACOs are motivated to work successfully because they are rewarded not for the number of completed tests or visits but based on the quality of care delivered and the improvements in their patient’s health (Centers for Medicare & Medicaid Services, 2021). What also incentivizes providers in reducing costs and succeeding in delivering high-quality care is that, in this case, CMS gives back some of the savings that the ACO generated for the Medicare program. However, if an ACO is not able to meet the requirements and goals set by CMS, it will either not get rewarded or will have to pay for its mistakes.
There are many benefits that patients receive from ACOs. For example, this program allows medical facilities and providers to step back and look at the problems from different perspectives, having enough time to make the best decision regarding taking care of their patients. ACOs are also about internal coordination and those incentives that are distributed between the providers. Patients can receive the best possible care at the highest quality and the lowest price. As for the providers, since most of them are initially interested in helping people and treating them with genuine concern and support, additional motivation in the form of bonuses increases the performance of healthcare facilities. Although ACOs are rather effective at saving patients’ money, and there are other ways people can reduce their costs while receiving proper care, the situation should be improved, and further research is needed to get valuable insights related to the topic.
References
Adams, L. (2019). 3 affordable financial safeguards to protect your health and income. Debt.com.
Centers for Medicare & Medicaid Services. (2021). Accountable care organizations (ACOs): General information. CMS.gov.
Doran, T., Maurer, K. A., & Ryan, A. M. (2017). Impact of provider incentives on quality and value of health care. Annual Review of Public Health, 38(1), 449-465.
Patient Assistance Program Center. (2021). The Web’s most current and comprehensive directory of Patient Assistance Programs. RxAssist.
