Better Coordinated Care
By Jonathan Blum, Acting Principal Deputy Administrator and Director, Center for Medicare
If you are like millions of Americans, you have seen multiple doctors or specialists for the same medical condition. And you might have noticed that, too often, those doctors don’t communicate with one another. That’s not just inefficient – it has the potential to be hazardous to your health.
Fortunately, the Affordable Care Act is helping create Accountable Care Organizations – new groups where doctors, nurses and specialists will work together to coordinate your care. Participation in these groups is entirely voluntary. Here’s one example of how this works:
- When a California Medicare beneficiary called to say she hadn’t been feeling well, her doctor’s office knew she was taking multiple medications for several health conditions. Because she thought she might be suffering from side effects, she stopped taking some of her pills.
- The office asked the ACO nurse case-manager to look in on the patient and the case-manager contacted the ACO’s pharmacist.
- The pharmacist then went through each prescription to determine where there might be interactions.
- He followed up with the patient’s specialists to make sure the prescriptions were right, and he followed up with the case-manager too.
This is just one example of how Accountable Care Organizations can make health care better for patients. We also know from experience that this kind of care also saves money for the Medicare program by preventing bigger health problems before they start.
And we’re so confident that the ACO approach will create a better, more affordable Medicare program that this program lets ACOs share in the savings they achieve.
Better-coordinated care is especially important for people with Medicare. One in five seniors has five or more chronic conditions. On average, they see 14 different doctors and get 50 prescriptions and refills a year.
While some initially doubted that doctors and hospitals would participate in ACOs, it’s now clear that this initiative offers a viable pathway toward delivering better, more affordable care to patients. Today, we announced the selection of 89 ACOs that will serve 1.2 million people with Medicare. That means that 154 ACOs that are already operating in cities and rural communities across the country are serving 2.4 million people with Medicare. These organizations are working hard to provide coordinated, patient-centered health care to Medicare beneficiaries to help them manage their health and stay out of hospitals and nursing facilities. And that could save the federal government as much as $940 million over four years.
When we look at ACOs we’re seeing a path to a more effective, less expensive health care of the future—just one of the ways the Affordable Care Act is putting all Americans on the road to better care and better health.