Measure in Obamacare makes way for new organization - WKRN News 2

Measure in Obamacare makes way for new kind of health organization

Posted: Updated: Oct 30, 2013 08:34 AM CDT
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NASHVILLE, Tenn. -

A measure in the Affordable Care Act is making way for a new kind of health organization.

Accountable Care Organizations seek to tie payment to the quality of care and a reduction in health care costs for a group of people.

Currently, providers are paid for every service which leads to a financial incentive for tests and procedures that may be unnecessary and expensive.

A local example of an Accountable Care Organization is MissionPoint, a subsidiary of St. Thomas Health.

From 2011 to 2012, MissionPoint is reporting a drop in hospital readmissions by 33% and emergency room visits are down 15%. That decrease translates to real cost savings and MissionPoint, where 50% of its members are on Medicare, is rewarded by Medicare for those results.

So how does it work? Care providers with MissionPoint are assigned a Medicare patient, usually someone who has been in and out of the hospital several times.

They make home visits, coordinate care providers, and attend to a member's spiritual and socioeconomic needs.

CEO Jason Dinger told News 2, "We've built wheelchair ramps, replaced hot water heaters; we really do whatever is necessary or required to improve that member's health and positive outcomes."

The results are beneficial, especially for hospitals seeking lower readmissions and emergency room visits.

A provision in the Affordable Care Act will penalize hospitals with reduced Medicare and Medicaid payments if it is determined readmissions are too high.

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