Integrating RTs in Accountable Care Organizations (ACOs)

By Vernon Pertelle posted 04-08-2014 10:12

Like

Despite the myriad of settings RTs have worked; we have not always been keen on embracing change, particularly when it has been driven by new payment systems or reengineering to reduce operational expense. Respiratory Therapists (RTs) are specialized professionals that help to improve the health and well-being of patients with respiratory illness. RTs have provided clinical services in acute care hospitals, long-term acute care and skilled nursing facilities, home care (skilled under Part A and durable medical equipment (DME) providers under Part B); as well as pulmonary rehabilitation, in medical groups alongside primary care physicians and have demonstrated value in meeting the complex needs of patients. In the era of The New Healthcare Normal, RTs are poised to be at the forefront of change and distinguish the profession as paramount in creating solutions under the Affordable Care Act (ACA) by serving in various roles in Accountable Care Organizations (ACOs).

An ACO is a network of physicians, hospitals and other providers, that share responsibility [or financial risk] in coordinating the care of patients with the goals of improving outcomes while reducing costs. Providers are jointly accountable to ensure cost effective care for their patients and are financially incentivized to cooperate and facilitate practical solutions that support quality and improved care for patients. Hospitals and physicians must meet specific quality benchmarks and the central theme is in managing patients with chronic disease through prevention and intervention that keeps the patient in low cost environments of care.

The Centers for Medicare & Medicaid Services (CMS) evaluates ACO quality performance using a pre-defined set of quality measures. The measures are related to patient and caregiver experience with the care, coordination of care and patient safety, and key to RT's role - appropriate use of preventive health services and improved care for at-risk populations [such as patients diagnosed with Chronic Obstructive Pulmonary Disease - COPD].

CMS will reward ACOs when they demonstrate through meaningful use data that it has saved money, provided high-quality care resulting in improved health outcomes; and prevented utilization of high-cost health care that occurs in the emergency room or from unscheduled hospital admissions. RTs are key to the success of ACOs particularly as it relates to the care, treatment and management of patients with COPD. RTs are integral to ACOs accomplishing their goals of high-quality, low cost health care.

So, now is the time to seize the day and create the framework of successful programs that contribute to the goals and objectives of Value Based Health Care (VBHC) delivered in ACOs; and become the authors of change versus waiting on the sidelines for it to occur.

0 comments

74 views

Blogs