Counting On Accountable Care

Like everything else related to health care reform and the Affordable Care Act, Accountable Care Organizations (ACOs) can be complicated. When something’s new and confusing, one impulse is to run screaming in the opposite direction or to simply ignore it. Unfortunately, in the case of ACOs, neither reaction is acceptable, according to those optical industry leaders we spoke with for this issue’s cover story. Optometrists must be proactive or risk being left behind, they say, warning that doing nothing could jeopardize the continued success, even existence, of their practices.

Coordinated care, of which ACOs are one example, is a trend that’s being encouraged by health care reform and its change from fee-for-service to outcomes-based payments and its financial incentives for reducing costs while improving patient care. While ACOs are still in their formative stages and the jury is still out about their success or failure, the facts are that they are here, they are growing, and it is now in the hands of each and every optometrist to decide where their place will be in them and make it happen. As one of the optical industry leaders quoted in the article put it: “Someone is not going to do this for you; you have to do this for yourself.”

After reading this month’s cover story on ACOs, at worst you’ll understand exactly what it is that you are running screaming from, but at best, you will learn how to benefit from this major culture change in health care delivery and reimbursement that has the potential for dramatically changing optometry’s place on the health care team.

The Centers for Medicare and Medicaid Services, insurance companies, networks of eyecare professionals, and other leaders have taken their places; they are choosing their teammates and determining who plays what position. Will you be in the game or watch from the sidelines? ■