Pandemic Pause: Systematic Review of Cost Variables for Ambulatory Care Organizations Participating in Accountable Care Organizations
Date
2/12/2021
Authors
Lieneck, Cristian H.
Weaver, Eric
Maryon, Thomas
Journal Title
Journal ISSN
Volume Title
Publisher
Multidisciplinary Digital Publishing Institute
Abstract
Ambulatory health care provider organizations participating in Accountable Care Organizations (ACOs) organizations assume costs beyond typical practice operations that are directly associated with value-based care initiatives. Identifying these variables that influence such costs are essential to an organization’s financial viability. To enable the U.S. healthcare system to respond to the COVID-19 pandemic CMS issued blanket waivers that permit enhanced flexibility, extension, and other emergency declaration changes to ACO reporting requirements through the unforeseen future. This relaxation and even pausing of reporting requirements encouraged the researchers to conduct a systematic review and identify variables that have influenced costs incurred by ambulatory care organizations participating in ACOs prior to the emergency declaration. The research findings identified ACO-ambulatory care variables (enhanced patient care management, health information technology improvements, and organizational ownership/reimbursement models) that helped to reduce costs to the ambulatory care organization. Additional variables (social determinants of health/environmental conditions, lack of integration/standardization, and misalignment of financial incentives) were also identified in the literature as having influenced costs for ambulatory care organizations while participating in an ACO initiative with CMS. Findings can assist ambulatory care organizations to focus on new and optimized strategies as they begin to prepare for the post-pandemic resumption of ACO quality reporting requirements once the emergency declaration is eventually lifted.
Description
Keywords
accountable care organizations, value-based care, ambulatory care, outpatient care, medical clinic, cost, Health Administration
Citation
Lieneck, C., Weaver, E., & Maryon, T. (2021). Pandemic pause: Systematic review of cost variables for ambulatory care organizations participating in accountable care organizations. Healthcare, 9(2), 198.
Rights
Rights Holder
© 2021 The Authors.
Rights License
This work is licensed under a Creative Commons Attribution 4.0 International License.