Choosing Between PCMH and ACO Models - Special Academic Support

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Patient-centered medical homes (PCMHs) and Accountable Care Organizations (ACOs) are two models of healthcare delivery that have the same objectives: To improve outcomes for patients at a reduced cost relative to standard care. However, there are differences between the two models. The PCMH model is a systems-based method that sets up structures that are synchronized to deliver wholesome medical care to the patient (Patel et al., 2020). On the other hand, an ACO is a refund model of healthcare delivery in which providers are answerable to a patients outcomes and stand to benefit from any savings made by the patient or medical scheme in the course of receiving medical care (Patel et al., 2020). Crucially, the ACO model seeks to offset the failures of the conventional model whereby patients pay a substantial sum of money in exchange for healthcare.

ACOs involve the coming together of hospitals, medical and clinical officers, and nurses to provide patients with coordinated care. For this to be effected, the patient and the providers must come into a contractual pact in which they set important terms such as the payment of financial incentives. Notably, most of the patients that are catered to by ACOs suffer from chronic illnesses and may require more than one healthcare provider at any given time. The collaborative ACO framework between clients and the providers sets out how the several providers will carry out their duties. Additionally, the providers in an ACO model may earn patient savings by reducing the repetition of services offered to the patient, minimizing costly medical errors, and offering the patient complementary care whereby each intervention builds on the previous one. The savings made by the ACO scheme is split amongst its providers according to terms set out in the contract.

PCMHs are healthcare facilities that must be certified as such and have structures that are. As the name suggests, PCMHs undertake to provide patient-centric medical care. They offer services that meet the patients health needs as well as their mental and emotional needs. Also, the healthcare providers must work together with the patients family to understand their preferences, culture, and the level of personal support they need as part of the patient-centered approach. Similar to ACOs, PCMHs coordinate care across the board to reduce costs for the patient. Another advantage of PCMHs is that their services are delivered commensurate with the level of urgency. Waiting times for patients are significantly reduced and the providers are very responsive to the patients needs.

More importantly for patients, both models can result in significant cost savings. Patel et al. (2020) point out that PCMHs often result in more cost savings as compared to ACOs. This can perhaps be explained by the fact that the ACO model is based on reimbursing the providers where savings are made in the course of healthcare delivery. Also, it can be explained by the fact that PCMHs are certified and therefore their structures have been assessed for proficiency in implementing cost savings. However, both models are significantly cheaper than standard care. For instance, inpatient care under the PCMH is about half of what one would spend under standard care.

Question

With the information that the PCMH model relatively is cheaper for the patient whereas the ACO model is incentive-based for healthcare providers, which model would you rather be a part of?

Reference

Patel, P., Vaidya, V., & Gupte, R. (2020). Accountable care organizations and patient-centered medical homes: health expenditures and health services. The American Journal of Accountable Care, 8(2), 1421. Web.

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