Navigation Links
Are accountable care organizations 'improving population health'?

NEW YORK (March 19, 2013) -- Accountable Care Organizations (ACOs), a key feature of the Affordable Care Act (ACA), aim to control health care costs, enhance quality in health care and improve population health. But what does "improving population health" really mean? This is the question asked in a new viewpoint article by Weill Cornell Medical College researchers published in the March 20 issue of the Journal of the American Medical Association (JAMA). The authors argue a clear definition is crucial in order to formulate effective health care and social service policy.

Section 3022 of the ACA, which created the Medicare Shared Savings ACO program, states the program "promotes accountability for a patient population."

"This phrase sets the tone for the meaning of population health as applied to ACOs -- implying that it is the health of the Medicare beneficiaries attributed to a provider organization, not the health of all people living in an ACO's geographic area," says lead author Dr. Douglas Noble, Commonwealth Fund Harkness Fellow in Health Care Policy and Practice in the Department of Public Health at Weill Cornell. Dr. Noble also serves as a public health physician and clinical lecturer in the global health, policy and innovation unit at Barts and the London School of Medicine and Dentistry in the United Kingdom.

"Many ACOs appear to interpret their responsibility for population health in medical terms -- that is, as a responsibility to provide preventive care for all their patients and care management for their patients with serious chronic diseases," says senior author Dr. Lawrence P. Casalino, the Livingston Farrand Associate Professor of Public Health and chief of the Division of Outcomes and Effectiveness Research at Weill Cornell. "This is a major step forward from the traditional model in medical care, which has been to focus on whatever patients appear in the physician's office, while the patient is in the office. However, it falls far short of working to improve the health of the population in a geographic area."

Despite the widespread use of the phrase "population health" tied to ACOs, it's not clear that ACOs actually have the incentives or the tools to improve the health of the entire community in which they are located, according to researchers.

"Population health depends not only on medical care, but also on social services, the public health system and, crucially, on socioeconomic factors, such as housing, education, poverty and nutrition," emphasize the Weill Cornell authors in their JAMA article. "Talking about ACOs as if they are focusing on improving population health -- as opposed to improving medical care for their populations of patients -- leads to a lack of clarity about what ACOs are doing about population health and may divert attention away from social and public health services and from socioeconomic factors critical to health."

The authors do not suggest that ACOs should be responsible for population health defined as the health of everyone in their geographic area, because few if any ACOs have the expertise, authority, and incentives to act effectively in the areas of public health, social services and socioeconomic determinants of health. Instead, they suggest that the phrase "population health" should be clearly defined, and not used loosely in relation to ACOs.

"When population health is clearly defined, it becomes possible to think more specifically about what needs to be done to improve it, whether and how ACOs can help, the types of organizations with which ACOs will need to cooperate and the incentives that ACOs -- and other organizations -- will need to improve the health of the population in their geographic area," says Dr. Casalino.

The authors note that it has been suggested by other experts that ACOs could possibly contribute to improving the health of the whole population by functioning as part of "Accountable Health Communities," in which ACOs would cooperate with other organizations to improve geographical population health. Whether or not this is possible, or how this would be done is a difficult and complicated issue.

"It will only be possible to have this debate if the phrase 'population health' is used clearly, and not as a vague way of referring to what ACOs are currently doing," says Dr. Noble. "Otherwise, it will be very difficult to understand what ACOs are doing, what they are not doing and what they should be doing, who can do these things, how they can be measured and how and for whom incentives should be created."


Contact: Lauren Woods
Weill Cornell Medical College

Related medicine news :

1. 15 top medical organizations agree on hormone therapy use
2. Health care organizations quest for reduced costs and improved quality
3. Organizations collaborate to support research on arthritis and aging
4. OutSkirts Press Publishes New Relationship Guide to Help People, Businesses, & Organizations Stretch Their Relationship Capital
5. Humanitarian organizations must do more for older people in emergencies
6. United Benefit Advisors Celebrates 10th Anniversary and Recognition as One of the Nation's Top 5 Employee Benefits Organizations
7. Three Leading Telecommunications and Technology Organizations Sponsor the AG Bell Listening and Spoken Language Knowledge Center
8. MinistryKeys: Using DISC Behavioral Analysis to Help Religious Organizations Achieve Goals for 2013
9. BlowMeCool Inc. Announces a New Affiliate Program for Organizations Promoting Women’s Health & Wellness
10. On March 1, 2013 SBSI Training & Development Solutions Went into Operations Providing Training and Development Solutions to Midsized and Large Organizations
11. Callahan honored for improving older adults health in their doctors offices
Post Your Comments:
(Date:11/27/2015)... (PRWEB) , ... November 27, 2015 , ... Dr. ... Medical Associates, Inc. and Dr. Tucker Bierbaum with Emergency Medicine at St., ... observed that both STEMI and Sepsis conditions present in similar ways and require time-critical ...
(Date:11/26/2015)... ... , ... Inevitably when people think Thanksgiving, they also think Holiday sales and ... Friday and Cyber Monday massage chair sales to receive the best pricing ... to find the best massage chair deals, they can see all of the coupons ...
(Date:11/26/2015)... ... ... Jobs in hospital medical laboratories and in the imaging field lead the many ... Medical Group . These fields, as well as travel nursing, ranked at ... through the company’s website, , The leading healthcare staffing agency released ...
(Date:11/26/2015)... ... November 26, 2015 , ... ... for mental health and wellness consultation, has collaborated with Women’s Web – ... their reader’s queries on topics on mental and emotional well-being relationship, life ...
(Date:11/25/2015)... ... , ... The holiday season is jam-packed with family dinners, ... attendees is of the utmost importance. Whether you are cooking at home for ... a try this holiday season. , Turkey Croquettes ,     Ingredients: , ...
Breaking Medicine News(10 mins):
(Date:11/25/2015)... , Nov. 25, 2015  The American Academy ... Gynecologists (ACOG), and the March of Dimes cheered ... Protecting Our Infants Act of 2015 (S.799), ... of newborns born exposed to drugs, such as ... bill,s introduction, all three organizations have worked together ...
(Date:11/25/2015)... Nov. 25, 2015 On Tuesday, November ... bellwether trial against Wright Medical Technology, Inc. for ... Conserve metal-on-metal hip implant device, awarded $11 million ... two week trial and three days of deliberations, ... device was defectively designed and unreasonably dangerous, and ...
(Date:11/25/2015)... November 25, 2015 Kitov Pharma ... (TASE: KTOV), a biopharmaceutical company focused on the development ... clinical conditions, today announced the closing of its previously ... ( ADSs ), each representing 20 ordinary shares of ... ADSs. The ADSs and warrants were issued in a ...
Breaking Medicine Technology: