Enchiladas… and Accountable Care Organizations

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Striving for a “Platinum Star” Through Healthcare Reform

As many of you already know, networking in healthcare is an amazing activity. Upon reaching out to a new contact, an email may one day land in your Inbox with something in the subject line such as “Enchiladas and Accountable Care Organizations”. Once the chuckling subsides, the realization hits that you have a new friend in healthcare half way across the country who understands the craziness of the business you’re in—and that a simple recipe for enchiladas is a metaphor for health care reform.

Enchiladas

I’ve been making enchiladas for over ten years and have found myself tweaking the recipe slightly to (hopefully and not always successfully) improve each batch—with my husband and five picky teenagers as the resident food critics. My latest batch earned a gold star and many accolades from my family, and the most recent enhancements have become permanent modifications for my enchilada recipe on file. I wish it were a platinum star, but at least I have something to strive for, and am definitely in agreement that change is generally good over time. Did I mention that “simple” is the key to the success of any recipe, as far as I’m concerned?

Accountable Care Organizations (ACOs)

The Health Care Reform Law is certainly not simple, but it is intended to improve the quality of care while controlling the associated costs in a patient-centric environment. This means that the healthcare delivery system is undergoing an overhaul along with the method of compensation for the services provided. For more details about ACOs, be sure to read Andy Edeburn’s article on the cover of this month’s newsletter: “Understanding ACOs in the New Healthcare Landscape”.

Do we have the right ingredients with the current recipe on file? My speculation is that the implementation of ACOs and value-based purchasing/payments will end up much like my enchilada recipe: a continual attempt to improve outcomes for all stakeholders—primarily for the consumer, i.e. the patient. As one of many components related to healthcare reform, providers must understand that their patients’ perception of the overall care they’ve received upon completion of the revenue cycle will affect their reimbursement for many years to come.