Imagine a health system that pays doctors and hospitals to keep you well, not just treat you when you're sick. A system where doctors woud have financial incentive to limit unnecessary tests and prod patients to excersise more. A system where hostpitals would benefit from-now this is really radical-keeping you out of the hospital. In the existing fee-for-service payment system used by Medicare and most private insurers, doctors get paid more by giving services, and hospitals make more by increasing admissions. With ACO's, doctors and hospitals would get paid based on their ability to hold down overall costs and meet quality-of-care indicators. In effect, their pay would be based on improving care, not driving more of it. If the ACO's fail to meet certain quality and cost savings targets, the providers in the ACO would face lower payments from Medicare.
On the frip side, the ACO's would also be awarded for keeping ptientes happy and meeting national quality standards such as making sure diabetics get regular foot exams and women get their annual mammograms. In effect, ACO's are an attempt to build integrated health systems. Let us lead your way into the new world of ACO's.