Patient Protection and Affordable Care Act

In the age of vast healthcare reform, the Patient Protection and Affordable Care Act (PPACA) supports multidisciplinary teams that can be made up of “nurses, nurse practitioners, primary care physicians, medical specialists, pharmacists, nutritionists, dietitians, social workers, and providers of alternative medicine” (Haas, 2011, p. 11), for example. Innovative healthcare delivery models have been created to achieve an interdisciplinary care delivery team. One such model is the Accountable Care Organization (ACO). An ACO is an organizational structure that includes the hospital and the primary care physician, along with other outpatient facilities,with the goal of achieving cost-effective care and accountable outcomes. Four areas need addressed to accomplish this:

  1. Care for patients across the continuum of care, in different institutional settings as well as the home
  2. Plan, prospectively, for budgets and resource needs
  3. Effectively use evidence-based protocols and comparative effectiveness research
  4. Develop and support comprehensive, valid, and reliable measurement of performance (Haas, 2011, p. 11).

Additionally, incentives are offered to decrease hospital admissions and emergency room visits through rigorous disease prevention and chronic condition treatment (Haas, 2011).

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An ACO benefits the patient several ways. For one, hospital care doesn’t stop at the door when they are discharged. Since the structure includes inpatient and outpatient facilities, care is congruent throughout the life of the patient. This would include medical records, a second benefit, that are part of the entire organization, not just limited to a particular facility. Finally, patient outcomes can be thoroughly monitored and adjusted accordingly (Haas, 2011). For example, if a patient was admitted to the hospital with a fractured hip, care from arrival to the ED to follow-up care at physical therapy would be streamlined and all providers would have access to the patient’s progress and outcomes. And if this patient had comorbidities that were well-managed by the PCP, hospital length of stay would perhaps not be extended due to issues related to those comorbidities.

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