We are about to get our first look at the Medical Home model. Accountable Care Organizations (ACOs) are umbrella organizations that include multiple teams of providers organized through the Medical Home model of care delivery, a model developed to provide better and coordinated care for the chronically ill, and to lower the cost of care through information sharing.
On Monday December 19, HHS Secretary Kathleen Sebelius announced that 32 leading health care organizations would band together to participate in a new Pioneer Accountable Care Organizations initiative. The Pioneer initiative will encourage primary care doctors, specialists and hospitals to provide better, more coordinated care for people on Medicare, a program that could save $1.1 billion over the next five years. The Pioneer ACO package includes increased compensation for delivery of better care, testing of innovative payment models, coordination with private payers, and a reduction of costs for Medicare. The Pioneer ACO is specifically designed for groups of providers with experience working together to coordinate better care for patients, that now familiar mantra of "improved patient outcomes".
On Monday December 19, HHS Secretary Kathleen Sebelius announced that 32 leading health care organizations would band together to participate in a new Pioneer Accountable Care Organizations initiative. The Pioneer initiative will encourage primary care doctors, specialists and hospitals to provide better, more coordinated care for people on Medicare, a program that could save $1.1 billion over the next five years. The Pioneer ACO package includes increased compensation for delivery of better care, testing of innovative payment models, coordination with private payers, and a reduction of costs for Medicare. The Pioneer ACO is specifically designed for groups of providers with experience working together to coordinate better care for patients, that now familiar mantra of "improved patient outcomes".
Now what does this have to do with the ophthalmic community? As my colleague Alistair Jackson noted in his December 19 post, we can see the future for optometry by looking outside the profession. The Medical Home model is our future and we need to learn the rules of the game. Primary care physicians will need to have their diabetic patients seen by eye care specialists. Hypertensive patients and a host of other types of patients will need eye care. Optometry will solidify its position in the referral process by referring obese, at-risk patients to the Medical Home. Relationships will be built and optometry will be viable in the future. For those of us who have been around long enough to remember Medicare parity in the 1980s, this is not just more of the same. It doesn't automatically apply across the board. Optometrists need to be individually proactive in using every tool at their disposal to leverage their way into these networks. It can be done and, yes, there are model practices in the profession already showing us the way.
Chuck Haine, O.D., M.S.
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