Is an ACO Right for My Practice?

Addressing Problems in Today’s Healthcare System

You know firsthand that today’s healthcare system has many serious issues. Meaningful use and other administrative requirements have left you spending more time with paperwork than patients. At the same time, healthcare costs continue to rise at an alarming rate. Over the years, many measures have been put into place in an attempt to control rising healthcare costs. HMOs and PPOs are two examples. Designed to shift financial risk to health care providers and health care plans, over time employers complained about limitations on their choices for care and about having to go through a “gatekeeper” for referrals to specialists.

Despite these and other efforts, healthcare costs have kept going up, while at the same time quality of care has declined. These days, the patient community, payers, and employers expect better value for care.

How Clinically Integrated Networks Help

A different way to approach healthcare. A clinically integrated network (CIN) is a group of providers who work together to coordinate patient care. Although the CIN does not do away with fee-for-service payments, provider incentives are based on better health outcomes instead patient volume. This brings the focus of healthcare back to patient wellness and quality of care, rather than managing patient appointments in 15-minute increments.

The CIN model brings the idea of provider responsibility back into the healthcare equation, which in turn encourages more coordination among different doctors. The CIN, governed by physicians, is then more motivated to invest in infrastructure that allows for better communication and higher quality care.

Keep Your Independence

When providers join Seton Health Alliance, they maintain full control over their practices, and continue running independently. Some resources, such as IT help and data collection infrastructure, are shared with other providers. We continue to find resources that will help physicians succeed in providing a high level of care.

Once a provider joins Seton Health Alliance, they are required to meet quality standards adopted by the governing Board of Directors. However, these standards are determined and measured by other physicians in a way that makes sense. Provider members can also influence how this measurement system is set. Committing to be involved with us means a commitment to better healthcare quality and a better patient experience.