You are the cheif executive officer of a large, technology- intensive hospital in a community of 200,000 people. The community includes two other, smaller community hospitals and a wide range of physicians and other providers working in private practice. Currently, you are paid a fixed amount by Medicare- the federal insurance program for the elderly- for every eligible admission to your hospital, based on the severity of the patient’s needs. Physicians and other providers in your community are paid fee-to-service.
The federal government has offered to form an accountable care organization (ACO) in your community that could accept a capitated annual payment for each person eligible for Medicare. Answer the following questions:
1. How would you go about deciding whether to accept the government’s offer?
2. Would you want to lead the ACO or just be apart of it?
3. Would you argue for or against accepting the federal offer? why?
4. If you wanted to proceed and lead the effort to form an ACO, how would you coordinate with the other local hospitals and providers?
5. How might you change the way care currently is organized in your community, given the new financial incentives embedded in a capitated rate?