A physician’s answering service directs all after-hours callers to the emergency room. Assessment of a non-urgent condition costs hundreds of dollars. A three-day hospital stay for questionable reasons costs almost $50,000.
Many ER visits and hospitalizations are unnecessary. Poor coordination of medical services and needless testing relentlessly drive costs upward. Higher costs do not assure better quality.
Control of runaway medical costs is a major goal of the Affordable Care Act of 2010. The legislation provides funding for accountable care organizations (ACOs) as one means for attaining better care at a lower price.
ACOs are modeled after health plans that have functioned effectively for years in various parts of our country. Systems developed by Inter-Mountain Medical Group of Utah, Kaiser Permanente Health Plans, and Mayo Health System are notable successes.
ACOs are scheduled to become operational in January 2012. The Department of Health and Human Services issued regulations for ACOs in late March. Initially, the enterprises will offer care to Medicare recipients.