January 2012 marks a formal beginning to one of the most fundamental effects of the health care reform movement, one of the most significant changes we have seen in our professional careers.
Medicare has approved the final rules for establishing Accountable Care Organizations (ACOs) and will be accepting applications until January 23, 2012 for those organizations that plan to begin operation on April 1, 2012. There will be another application deadline in March for organizations beginning July 1, 2012.
So why is this significant for us as eye care providers? Because it directly affects our access to patients. ACOs are structured around coordination of patient care and a whole new reimbursement system that replaces the standard medicare fee-for-service payment model. ACOs are able to participate in the cost savings they generate as long as they are simultaneously able to demonstrate they are improving the quality of care delivered. The demonstration period for ACOs is now past and any health care organization anywhere in the country that meets the criteria can apply for participation.
Once ACOs are up and running in your area, they will affect your access to patients. If you understand the process, properly prepare and actively demonstrate your value to your local ACOs, they can be very good for your business. If you don’t prepare, no one is going to send you an invitation, and the ACO could limit your access to both your current patients and potential future patients.
You owe it to yourself to become knowledgeable about ACOs, what they are, how they will function, and what they mean to the future of your practice. For the benefit of your business, you need to be involved in a local ACO.
Jim Grue, O.D.
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